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. The Scapula The Dorsal surface of the Scapula is divided into two regions by the spine of the Scapula Right Side 11. Clipping is a handy way to collect important slides you want to go back to later. Often representing more than just a cosmetic deformity of the shoulder, it can lead to significant pain and functional impairment. In simple terms, scapular winging is a movement dysfunction of the shoulder blade. By Tony Tompos. You can change your ad preferences anytime. 3cm (Figure 2). Volume 2 - Issue - 4 The patient was also prescribed 0.05% [1]. The scapula plays many roles in shoulder function. 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. cortico-cancellous iliac crest bone graft (Figure 3). trapezius muscle strengthening. extended, the deformity disappeared. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. On the first follow up after 2 weeks The composite scapular motion of rotation, abduction, and tilting is necessary for proper shoulder function. Scapular winging is a painful and debilitating condition. A winged scapula is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. Anatomy 5 ppt 1. Scapular winging involves one or both shoulder blades sticking out from the back rather than lying flat. It becomes more prominent in the cocking position and after repetitive elevation of the upper extremity. This can be due to a deficit in the trapezius muscle as a … Yet, with scapular dyskinesis, the shoulder blade comes off the rib cage. It can be classified as primary, secondary, or voluntary. clavicle fracture following a motor vehicle accident. Frequently, the observational and functional result of the injury is prominence of the medial scapular border, commonly called “winged scapula”. These muscles both stabilise the arm to the body and move the arm around in space. Scapular winging, one of the more common scapulothoracic disorders, is caused by a number of pathologic conditions. If you continue browsing the site, you agree to the use of cookies on this website. Isolated scapula pain is uncommon, but very difficult to diagnose and manage. 9-1 Chapter 9 Joints 2. 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. If you continue browsing the site, you agree to the use of cookies on this website. Winging of the scapula is a surprisingly common physical sign, but because it is often asymptomatic it receives little attention. Wings to the Research Scapular winging, sometimes called a winged scapula, is a condition that affects the shoulder blades. Downloads. On SlideShare. Scapular dyskinesia and its relationship to rotator cuff impingement syndrome, S.I.C.K. If you continue browsing the site, you agree to the use of cookies on this website. The clavicle fracture was treated surgically with A normally functioning scapula rests on the rib cage during all movements. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. 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. 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. In some serious cases, the ability to perform activities of daily living such as changing one's … The commonest cause of scapular winging is isolated serratus anterior muscle (SAM) paralysis [ 2 ]. Figure 1: Right scapula winging. of surgery, complete resolution of winging. Nerve conduction study of the long thoracic and spinal 29.1 Introduction. Winging Scapula is a dysfunction of the stabilizing muscles of the scapula. Neurological Musculoskeletal Perhaps, you or a friend, has once shown the other what crazy stuff they can do with their shoulder blade. Looks like you’ve clipped this slide to already. open reduction and internal fixation using a distal clavicle locking Karunakgaran K1 Electrodiagnostic testing can help to establish the underlying neuromuscular pathology. Scapula is the anatomical term for the shoulder blade. 0 Number of Embeds. Proximal muscle power of the right upper limb was of 3/5 with preserved distal muscle power. A brief review on scapula fractures diagnosis and management. Introduction was prominence of the medial border of the right scapula which compression plate (Synthes®) and augmented with autologous Figure 2: Chest radiograph showing right clavicle mid- This abnormal position of the scapula can lead to many physical functional disabilities such as pain, decrea … In most cases, the practitioner can evaluate scapular winging with a proper history and physical examination. Clavicle fracture association with scapula winging is a rare right mid-clavicular area and crepitus upon attempted shoulder shaft fracture with 3cm shortening. Case Report Shares. Lack of stability and mobility may lead to scapula winging. Now customize the name of a clipboard to store your clips. A patient of FSHD (facio scapulo humeral dystrophy It is pertinent to note that this is a surgically correctible condition (the winging of scapula). Winging of the scapula Scapula dyskinesis Sick scapula . Types of Scapular Dyskinesis Type 2 - Medial border prominence This pattern displays winging of the entire medial border of the scapula at rest. It can affect a person's ability to lift, pull, and push weighty objects. As a result, the medial border of the scapula protrudes, like wings. Clipping is a handy way to collect important slides you want to go back to later. entity.Prevalenceofscapula winginginclaviclefracturesislessthan We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. We examined these cases for presenting or preexisting diagnoses and for surgical procedures that had been performed before the diagnosis of scapular winging. *Corresponding author: Karunakgaran K, Department of Orthopaedic, Malaysia Lateral winging 4: On exam, the superior medial scapula drops downward and protrudes posterior and lateral (see figure 3). Abstract 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. In a patient who has a winged scapula, the medial or lateral aspect of scapula appears to be protruding from the back. It is caused by fatigue of the scapula stabilising muscles (trapezius and rhomboids) (Funk, 2013). up after 2 months of post-operative, she had good shoulder range Upon pushing both palms against the wall with the elbows Submission: September 22, 2017; Published: May 18, 2018 It can happen as a result of injury or nerve damage. 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. Copyright © Karunakgaran K In most cases, winging of the scapula is not seen immediately but may take weeks to become obvious. Winging of the scapula is often associated with palsy of the serratus anterior muscle, but can be due to numerous pathologic processes. A previously healthy 21-year-old Malay girl presented to our We report a case of a patient who sustained closed comminute mid-shaft right clavicle fracture with ipsilateral scapula winging. Posterior, there second day after surgery (Figure 4). the serratus anterior, trapezius and rhomboid muscles were physiotherapy with emphasis on serratus anterior, rhomboid and It is when the medial border of the scapula begins to sick out, and upper body flexion and abduction are impaired. 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. The main reasons for this condition are musculoskeletal- and neurological-related. She had If you continue browsing the site, you agree to the use of cookies on this website. Case Report Diabetic Foot Ulcers: Where Do We Currently Stand-Crimson Publishers. Serratus anterior is a muscle on the front medial part of the scapula and inserts onto the first eight ribs. was also displaced laterally (Figure 1). This case highlights the value of considering a compressive lung pathology with infiltration in the differential diagnosis, when evaluating winging of the scapula. 159Copyright © All rights are reserved by Karunakgaran K. Looks like you’ve clipped this slide to already. You can change your ad preferences anytime. If you continue browsing the site, you agree to the use of cookies on this website. complete resolution of the scapular winging upon inspection on the The diagnosis was commonly missed for a considerable interval. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 1. association with malunions and non-union’s of acromian fractures See our Privacy Policy and User Agreement for details. 268 Comments. However, symptoms of pain, weakness, or cosmetic deformity may demand attention, and it is hoped that this classification will help in … Scapular winging is abnormal scapulothoracic posture and motion resulting from numerous underlying etiologies. Scapular Dyskinesis Evaluation. 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. MSc Physiotherapy Student Placement [3], as well as clavicle fractures [3]. Department of Orthopaedic, Malaysia. Online JournalC CRIMSON PUBLISHERS displaced comminute clavicle shaft fracture with a shortening of normal. Since 1930, avulsions of the serratus anterior have been reported as a cause of scapular winging. Musculoskeletal Out-Patients Primary scapular winging may be due to neurologic injury, pathologic changes in the bone, or … Damage to the long thoracic nerve is a classic cause of Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal. Consent Scapula Winging With a Clavicle Fracture: A Case This results in an imbalance and/or an irregular motion of the scapula. first year) references: bhargava (textbook of radiology); butlers (applied radiological anatomy) and radiological websites. See our User Agreement and Privacy Policy. 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. 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 Anatomically, it is the “G” of the glenohumeral (G-H) joint and the “A” of the acromioclavicular (A-C) joint. There was near 2016 – firstedition by- shaikh mehziyar abbas qamar abbas anatomy (vol-1) (for b.p.m.t. How to Treat Winged Scapula. motion. Specific assessment of Winging of scapula results from paralysis of the muscles that keeps the scapula anchored to the chest wall. Injury to the scapula and its musculature is not uncommon. Scapular winging is a disabling condition that hinders the ability to lift, pull, and push against objects. Examination revealed a deformity in the 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.) Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. On examination, winging of scapula on the right side was noted with wasting and fasciculation involving the ipsilateral shoulder girdle. medial scapula winging [2]. See our User Agreement and Privacy Policy. winging is caused by scapular dyskinesia secondary to shortening of the clavicle. Radiographs revealed a of motion. 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). How it can be elicited clinically. The winging There was no evidence of brachial plexus injury clinically The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. During second follow Now customize the name of a clipboard to store your clips. 12 Actions. We suspect that the 'Winging' of the scapula describes the abnormal lifting of the medial (vertebral) border of the scapula away from the thoracic wall. Winged Scapula, also known as Scapular Winging, is a condition that affects the shoulder blades. Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal See our Privacy Policy and User Agreement for details. This video educates about winging of scapula, how it looks like? Orthopedic Research Chap09 Joints 1. Report There are reports of scapula winging in limited shoulder abduction and flexion due to pain. … 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. The serratus Anterior holds your shoulder blades against the ribcage. other significant injuries. 0 From Embeds. 0. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. She had no The most common causes … Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Scapula Winging. as her sensory and motor examination was all normal. The Scapula The region below the Scapular Spine is the Infraspinous Fossa Right Side 12. * and Taran Singh Pall Singh2 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. clinic 6 weeks after sustaining a closed comminute mid-shaft right persisted for 4 weeks after the fracture and spontaneously resolved after open reduction and internal fixation of right clavicle. It means the shoulder blade must be mobile and stable. The Scapula Anterior / Ventral surface Posterior / Dorsal Surface The scapula has two surfaces Right Side 10. 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