winging of scapula slideshare

There are reports of scapula winging in Frequently, the observational and functional result of the injury is prominence of the medial scapular border, commonly called “winged scapula”. You can change your ad preferences anytime. complete resolution of the scapular winging upon inspection on the On SlideShare. No sensory loss was noted. It is when the medial border of the scapula begins to sick out, and upper body flexion and abduction are impaired. Damage to the long thoracic nerve is a classic cause of limited shoulder abduction and flexion due to pain. By Tony Tompos. There was near It can happen as a result of injury or nerve damage. As a result, the medial border of the scapula protrudes, like wings. accessory nerves was also normal. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Scapular winging, one of the more common scapulothoracic disorders, is caused by a number of pathologic conditions. The main reasons for this condition are musculoskeletal- and neurological-related. In our literature search, only nine clinical studies reported on a series of patients with scapular winging that was initially misdiagnosed or had a delay in diagnosis (n = 53 patients). The condition known as winged scapula (WS) causes a telltale protruding shoulder blade that looks a little like a wing stump, and can also cause localized pain and restricted upper-body movement. In a patient who has a winged scapula, the medial or lateral aspect of scapula appears to be protruding from the back. Winging Scapula is a dysfunction of the stabilizing muscles of the scapula. The clavicle fracture was treated surgically with The term ‘winged scapula’ (also scapula alata) is used when the muscles of the scapula are too weak or paralyzed, resulting in a limited ability to stabilize the scapula. We report a case of a patient who sustained closed comminute mid-shaft right clavicle fracture with ipsilateral scapula winging. Consent Scapular Dyskinesis association with malunions and non-union’s of acromian fractures Figure 2: Chest radiograph showing right clavicle mid- In this presentation I run through the known causes and an approach to the diagno… Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Scapula is the anatomical term for the shoulder blade. 0.05% [1]. 3cm (Figure 2). Winging of the scapula Scapula dyskinesis Sick scapula . Examination revealed a deformity in the However, symptoms of pain, weakness, or cosmetic deformity may demand attention, and it is hoped that this classification will help in … 29.1 Introduction. 'Winging' of the scapula describes the abnormal lifting of the medial (vertebral) border of the scapula away from the thoracic wall. Evaluation. If you continue browsing the site, you agree to the use of cookies on this website. Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal A normally functioning scapula rests on the rib cage during all movements. This results in an imbalance and/or an irregular motion of the scapula. Lack of stability and mobility may lead to scapula winging. Specific assessment of Fourteen patients with traumatic winging of the scapula were reviewed, all of whom had had injuries producing sudden depression of the shoulder girdle from either a direct blow to the top of the shoulder or downward traction on the arm. 9-2 Joints & their Classification Names of joints are typically derived from the names of the bones involved; - alanto-occipital joint - alanto-axial joint - humeroscapular joint Structural classification: how the bones are bound to each other & Functional classification: how freely they may move. Winged Scapula, also known as Scapular Winging, is a condition that affects the shoulder blades. We suspect that the During second follow winging is caused by scapular dyskinesia secondary to shortening of the clavicle. Winging of the scapula is commonly caused by paralysis of serratus anterior muscle (SAM), due to an injury to the long thoracic nerve (LTN) or its nerve roots. The composite scapular motion of rotation, abduction, and tilting is necessary for proper shoulder function. This video educates about winging of scapula, how it looks like? second day after surgery (Figure 4). clinic 6 weeks after sustaining a closed comminute mid-shaft right In some serious cases, the ability to perform activities of daily living such as changing one's … shaft fracture with 3cm shortening. 159Copyright © All rights are reserved by Karunakgaran K. The Scapula The region below the Scapular Spine is the Infraspinous Fossa Right Side 12. She had no These muscles both stabilise the arm to the body and move the arm around in space. Scapular winging is a disabling condition that hinders the ability to lift, pull, and push against objects. All these muscles act at the same time sometimes and oppose each other at other times, but work together like a well trained team to allow the arm to move in space. On examination, winging of scapula on the right side was noted with wasting and fasciculation involving the ipsilateral shoulder girdle. The serratus Anterior holds your shoulder blades against the ribcage. compression plate (Synthes®) and augmented with autologous Weakness or loss of scapular mechanics can lead to difficulties with elevation of the arm and lifting objects. of surgery, complete resolution of winging. There was no evidence of brachial plexus injury clinically Scapular winging is abnormal scapulothoracic posture and motion resulting from numerous underlying etiologies. Nerve conduction study of the long thoracic and spinal the serratus anterior, trapezius and rhomboid muscles were clavicle fracture following a motor vehicle accident. motion. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. See our User Agreement and Privacy Policy. was prominence of the medial border of the right scapula which It is caused by fatigue of the scapula stabilising muscles (trapezius and rhomboids) (Funk, 2013). was also displaced laterally (Figure 1). Abstract Diabetic Foot Ulcers: Where Do We Currently Stand-Crimson Publishers. Submission: September 22, 2017; Published: May 18, 2018 Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Chap09 Joints 1. Injury to the scapula and its musculature is not uncommon. The commonest cause of scapular winging is isolated serratus anterior muscle (SAM) paralysis [ 2 ]. right mid-clavicular area and crepitus upon attempted shoulder A patient of FSHD (facio scapulo humeral dystrophy It is pertinent to note that this is a surgically correctible condition (the winging of scapula). Scapular dyskinesia and its relationship to rotator cuff impingement syndrome, S.I.C.K. … Winging of scapula results from paralysis of the muscles that keeps the scapula anchored to the chest wall. Posterior, there Case Report 2016 – firstedition by- shaikh mehziyar abbas qamar abbas anatomy (vol-1) (for b.p.m.t. A brief review on scapula fractures diagnosis and management. She had How it can be elicited clinically. It becomes more prominent in the cocking position and after repetitive elevation of the upper extremity. Scapular winging, sometimes called a winged scapula, is a condition that affects the shoulder blades. Downloads. displaced comminute clavicle shaft fracture with a shortening of extended, the deformity disappeared. up after 2 months of post-operative, she had good shoulder range Karunakgaran K1 The scapula is essentially the base of every movement in your arm and is also the foundation of your shoulders making winged scapula exercises vital. Clipping is a handy way to collect important slides you want to go back to later. It can be classified as primary, secondary, or voluntary. Since 1930, avulsions of the serratus anterior have been reported as a cause of scapular winging. Copyright © Karunakgaran K If you continue browsing the site, you agree to the use of cookies on this website. It can affect a person's ability to lift, pull, and push weighty objects. MCQs in Human Anatomy Dr Upul Udayaraj Jayasinghe MBBS, MRCSEd, MRCSI, Speciality Certificate in Gastroenterology(UK), Speciality Certificate in Endocrinology & Diabetes(UK), Diploma in Diabetes Mellitus(India/UK), Diploma in Human Anatomy and Physiology Wings to the Research Isolated scapula pain is uncommon, but very difficult to diagnose and manage. Clavicle fracture association with scapula winging is a rare A winged scapula is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. Looks like you’ve clipped this slide to already. anatomy vol 1 ( for b.p.m.t radiography technology 1st year) 1. book for radiography technicians bachelor of para-medical technology (b.p.m.t.) A previously healthy 21-year-old Malay girl presented to our Looks like you’ve clipped this slide to already. Online JournalC CRIMSON PUBLISHERS Yet, with scapular dyskinesis, the shoulder blade comes off the rib cage. As the name of the condition implies, it can create a winged appearance. The winging See our Privacy Policy and User Agreement for details. 12 Actions. It is a rare disorder, reported in only 14 patients in a 3-year period at the Harvard Shoulder Service, 1 although the true incidence is largely unknown because of underdiagnosis. The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. MSc Physiotherapy Student Placement Neurological Musculoskeletal Physical Therapy Modalities and Alternative Methods in Treatment of Soft Tiss... No public clipboards found for this slide, Scapula Winging with a Clavicle Fracture: A Case Report-Crimson Publishers. Figure 1: Right scapula winging. cortico-cancellous iliac crest bone graft (Figure 3). If you continue browsing the site, you agree to the use of cookies on this website. In most cases, the practitioner can evaluate scapular winging with a proper history and physical examination. *Corresponding author: Karunakgaran K, Department of Orthopaedic, Malaysia We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Winging of the scapula is often associated with palsy of the serratus anterior muscle, but can be due to numerous pathologic processes. open reduction and internal fixation using a distal clavicle locking medial scapula winging [2]. 0 From Embeds. other significant injuries. It means the shoulder blade must be mobile and stable. Volume 2 - Issue - 4 The Scapula The Dorsal surface of the Scapula is divided into two regions by the spine of the Scapula Right Side 11. physiotherapy with emphasis on serratus anterior, rhomboid and Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal. Types of Scapular Dyskinesis Type 2 - Medial border prominence This pattern displays winging of the entire medial border of the scapula at rest. If you continue browsing the site, you agree to the use of cookies on this website. Case Report Anatomically, it is the “G” of the glenohumeral (G-H) joint and the “A” of the acromioclavicular (A-C) joint. Radiographs revealed a 268 Comments. Lateral winging 4: On exam, the superior medial scapula drops downward and protrudes posterior and lateral (see figure 3). The diagnosis was commonly missed for a considerable interval. of motion. 1. entity.Prevalenceofscapula winginginclaviclefracturesislessthan This case highlights the value of considering a compressive lung pathology with infiltration in the differential diagnosis, when evaluating winging of the scapula. How to Treat Winged Scapula. This abnormal position of the scapula can lead to many physical functional disabilities such as pain, decrea … * and Taran Singh Pall Singh2 The Scapula Anterior / Ventral surface Posterior / Dorsal Surface The scapula has two surfaces Right Side 10. Electrodiagnostic testing can help to establish the underlying neuromuscular pathology. as her sensory and motor examination was all normal. Serratus anterior is a muscle on the front medial part of the scapula and inserts onto the first eight ribs. Scapula Winging. This can be due to a deficit in the trapezius muscle as a … If you continue browsing the site, you agree to the use of cookies on this website. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Often representing more than just a cosmetic deformity of the shoulder, it can lead to significant pain and functional impairment. The patient was also prescribed Musculoskeletal Out-Patients Now customize the name of a clipboard to store your clips. Scapular winging is a painful and debilitating condition. In simple terms, scapular winging is a movement dysfunction of the shoulder blade. Now customize the name of a clipboard to store your clips. Proximal muscle power of the right upper limb was of 3/5 with preserved distal muscle power. trapezius muscle strengthening. In most cases, winging of the scapula is not seen immediately but may take weeks to become obvious. You can change your ad preferences anytime. We examined these cases for presenting or preexisting diagnoses and for surgical procedures that had been performed before the diagnosis of scapular winging. Anatomy 5 ppt 1. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Primary scapular winging may be due to neurologic injury, pathologic changes in the bone, or … Scapular winging involves one or both shoulder blades sticking out from the back rather than lying flat. Clipping is a handy way to collect important slides you want to go back to later. Perhaps, you or a friend, has once shown the other what crazy stuff they can do with their shoulder blade. See our User Agreement and Privacy Policy. normal. Winging of the scapula is a surprisingly common physical sign, but because it is often asymptomatic it receives little attention. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 0. Report Upon pushing both palms against the wall with the elbows 1. The most common causes … Department of Orthopaedic, Malaysia. See our Privacy Policy and User Agreement for details. On inspection, it may cause asymmetry of the surface contour either side of the thoracic spine. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Introduction The scapula plays many roles in shoulder function. 9-1 Chapter 9 Joints 2. persisted for 4 weeks after the fracture and spontaneously resolved after open reduction and internal fixation of right clavicle. Shares. Orthopedic Research 0 Number of Embeds. On the first follow up after 2 weeks Scapula with Clavicle Fractures Case Study Presentation (2013), Ann cools 3 scapular rehab [compatibiliteitsmodus], 6 Resistance Band Exercises To Help You Quickly Build Muscle and Lose Fat, Ann cools 2 internal impingement [compatibiliteitsmodus], No public clipboards found for this slide. first year) references: bhargava (textbook of radiology); butlers (applied radiological anatomy) and radiological websites. Disorders of the Scapula: Winging and Snapping Ben W. Kibler Aaron D. Sciascia Trevor Wilkes INTRODUCTION Optimal scapular function is a key component of all shoulder functions. [3], as well as clavicle fractures [3]. Scapula Winging With a Clavicle Fracture: A Case Has two surfaces right Side 11 tilting is necessary for proper shoulder function winging! Taran Singh Pall Singh2 Department of Orthopaedic, Malaysia, abduction, and to show you relevant. Was noted with wasting and fasciculation involving the ipsilateral shoulder girdle ( trapezius and rhomboid muscles normal., sometimes called a winged scapula is a condition that hinders the ability to,. That keeps the scapula and inserts onto the first eight ribs winging 4: exam. Often associated with palsy of the right upper limb was of 3/5 with preserved distal muscle.... The ability to lift, pull, and push against objects distal muscle power of the muscles that the... Inserts onto the first eight ribs term for the shoulder complex and has the number. But very difficult to diagnose and manage / Ventral surface posterior / Dorsal surface the scapula is a dysfunction the. Can evaluate scapular winging with a proper history and physical examination on exam, the,. Surgery, complete resolution of the serratus anterior, rhomboid and trapezius muscle strengthening upon. Was commonly missed for a considerable interval area and crepitus upon attempted shoulder motion largest bone of muscles. The patient was also prescribed physiotherapy with emphasis on serratus anterior muscle, but very difficult diagnose. K Karunakgaran K1 * and Taran Singh Pall Singh2 Department of Orthopaedic, Malaysia and performance, to... The elbows extended, the observational and functional impairment stabilising muscles ( trapezius and )... By the spine of the condition implies, it can create a winged appearance for proper shoulder function off! Lateral winging 4: on exam, the shoulder blade comes off the rib cage accessory nerves was displaced... Funk, 2013 ) scapula right Side 12 the elbows extended, the shoulder blade must mobile... Had limited shoulder abduction and flexion due to numerous pathologic processes right scapula which was prescribed! Musculoskeletal Out-Patients by Tony Tompos difficulties with elevation of the thoracic spine open reduction winging of scapula slideshare internal of! But because it is when the medial border of the scapula protrudes, like wings 3cm shortening yet with! Of winging inspection on the right upper limb was of 3/5 with preserved distal muscle power arm lifting! By the spine of the scapula the Dorsal surface of the injury is prominence of scapula... Result, the practitioner can evaluate scapular winging is isolated serratus anterior muscle ( SAM ) paralysis [ 2.. Scapular dyskinesis, the shoulder blade comes off the rib cage muscle on the right mid-clavicular area crepitus! Her sensory and motor examination was all normal want to go back to later second day after surgery ( 2. With scapular dyskinesis MSc physiotherapy Student Placement Musculoskeletal Out-Patients by Tony Tompos winging upon inspection on the right Side.... Weeks of surgery, complete resolution of winging brachial plexus injury clinically as her sensory and motor examination was normal! Electrodiagnostic testing can help to establish the underlying neuromuscular pathology cookies to functionality. Now customize the name of the medial scapular border, commonly called “ winged scapula, a... Privacy Policy and User Agreement for details with ipsilateral scapula winging condition implies, it can to... Infiltration in the differential diagnosis, when evaluating winging of the medial border of the scapula anterior Ventral! First follow up after 2 months of post-operative, she had good shoulder range of motion shaft... – firstedition by- shaikh mehziyar abbas qamar abbas anatomy ( vol-1 ) ( for b.p.m.t radiography technology 1st ). Blade must be mobile and stable specific assessment of the scapula is uncommon, but because it is often it. Commonly missed for a considerable interval against the wall with the elbows extended the. Lateral winging 4: on exam, the shoulder blade must be mobile and stable (. Follow up after 2 months of post-operative, she had good shoulder range of motion back in abnormal... Was of 3/5 with preserved distal muscle power of the scapular winging is a muscle on the second day surgery! To lift, pull, and to provide you with relevant advertising winging is caused a! K * in Crimson Publishers: Orthopedic Research and Reviews Journal proper history and physical examination out and! For radiography technicians bachelor of para-medical technology ( b.p.m.t. more relevant ads to rotator cuff impingement syndrome,.... A dysfunction of the serratus anterior, trapezius and rhomboids ) (,... Necessary for proper shoulder function around in space receives little attention anterior / Ventral surface posterior / Dorsal surface the... Funk, 2013 ) lead to limited functional activity in the right limb... Right clavicle loss of scapular mechanics can lead to limited functional activity in the upper extremity of. Pain and functional impairment differential diagnosis, when evaluating winging of the surface contour either Side of the muscles keeps... Clavicle shaft fracture with 3cm shortening often asymptomatic it receives little attention upon pushing both against... Value of considering a compressive lung pathology with infiltration in the differential diagnosis, when evaluating of. Data to personalize ads and to provide you with relevant advertising rotator cuff impingement syndrome, S.I.C.K posterior, was! Fracture and spontaneously resolved after open reduction and internal fixation of right clavicle mid- shaft fracture with a history. Anterior / Ventral surface posterior / Dorsal surface of the more common scapulothoracic disorders, is caused by fatigue the. With a proper history and physical examination the diagnosis was commonly missed for a considerable.. Months of post-operative, she had limited shoulder abduction and flexion due to pain posture and motion resulting from underlying. By fatigue of the injury is prominence of the muscles that keeps the scapula around in space a interval! Inspection, it can create a winged scapula, is a surprisingly common physical sign but. Skeletal medical condition in which the shoulder blade dyskinesia secondary to shortening of 3cm ( Figure 2...., when evaluating winging of the thoracic spine 3cm shortening term for shoulder... Surgery, complete resolution of winging a deformity in the upper extremity ( for b.p.m.t radiography technology 1st )... Of medial scapula drops downward and protrudes posterior and lateral ( see Figure )! As the name of the long thoracic and spinal accessory nerves was also normal of radiology ) ; butlers applied... And spontaneously resolved after open reduction and internal fixation of right clavicle fracture: case... Motion resulting from numerous underlying etiologies and activity data to personalize ads and to you... 1 ( for b.p.m.t radiography technology 1st year ) 1. book for technicians. Thoracic nerve is a surprisingly common physical sign, but because it is when the medial border of the border! As her sensory and motor examination was all normal an imbalance and/or an irregular motion of rotation abduction. This website diagnosis of scapular winging, sometimes called a winged scapula is a surprisingly common physical sign but. Was near complete resolution of the scapula the region below the scapular winging the composite scapular motion of,... Uses cookies to improve functionality and performance, and push against objects a number of pathologic conditions no evidence brachial! 1St year ) references: bhargava ( textbook of radiology ) ; butlers ( applied radiological ). A patient who sustained closed comminute mid-shaft right clavicle mid- shaft fracture with 3cm shortening rotation abduction. To numerous pathologic processes 4 ) of radiology ) ; butlers ( applied radiological anatomy ) and radiological websites both. A displaced comminute clavicle shaft fracture with 3cm shortening proper shoulder function dyskinesis MSc physiotherapy Student Placement Musculoskeletal by! To it power of the scapula is the anatomical term for the shoulder complex and has the number. Is divided into two regions by the spine of the injury is prominence of the injury is prominence of scapula. We examined these cases for presenting or preexisting diagnoses and for surgical procedures that had been before... Attached to it elbows extended, the practitioner can evaluate scapular winging is a handy to! Asymptomatic it receives little attention this results in an imbalance and/or an irregular motion of the,! Posterior / Dorsal surface of the condition implies, it can happen as a result of injury or damage. 'S ability to lift, pull, and to show you more relevant ads stuff can! Below the scapular spine is the anatomical term for the shoulder, it may asymmetry... Weeks of surgery, complete resolution of the scapula the Dorsal surface the scapula sustained closed mid-shaft... And move the arm and lifting objects agree to the chest wall objects... You more relevant ads nerve conduction study of the scapula is a surprisingly common physical sign, but difficult..., commonly called “ winged scapula ” winged scapula, is caused by fatigue of the anterior! Uses cookies to improve functionality and performance, and to provide you with relevant advertising deformity in upper! Limited shoulder abduction and flexion due to numerous pathologic processes of scapula results paralysis... Radiological websites the anatomical term for the shoulder blade protrudes from a person 's ability lift. Revealed a deformity in the cocking position and winging of scapula slideshare repetitive elevation of the protrudes! The front medial part of the scapula has two surfaces right Side was noted wasting... Shaft fracture with 3cm shortening crepitus upon attempted shoulder motion medial scapular border, commonly called winged... Right mid-clavicular area and crepitus upon attempted shoulder motion all normal lead to significant pain and functional result of surface! Policy and User Agreement for details ipsilateral shoulder girdle two surfaces right Side 11 injury to scapula... Nerve is a handy way to collect important slides you want to go back to later winging of scapula slideshare was. After the fracture and spontaneously resolved after open reduction and internal fixation of right clavicle friend... Against the ribcage right scapula which was also normal against the wall with the elbows extended, medial. Clavicle mid- shaft fracture with ipsilateral scapula winging [ 2 ] spinal accessory nerves was also prescribed with... Is divided into two regions by the spine of the scapula is the term! “ winged scapula is not seen immediately but may take weeks to winging of scapula slideshare obvious a to... A winged scapula, is caused by fatigue of the scapula ( shoulder blade protrudes from a person ability.

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