Winged scapula is caused by muscular injury or damage to corresponding muscular innervation. Mechanism can be due to blunt or penetating thoracic trauma.

• Trapezius muscle
  • Long thoracic nerve
• Serratus Anterior muscle
  • Spinal Accessory Nerve

Clinical findings include

• Protruding medial edge of the scapula
• Exacerbation by pushing against resistance
• Difficulty lifting arm over head

Treatments

• Initial splinting and orthopedic referral
• Depending on mechanism - trial of physical therapy
• Surgical treatments include fascial grafts or adjacent muscle attachment

References