Scapula Winging

Primary            

 

Due to ST articulation disorder

 

1.  Neurological

 

A.  Spinal accessory nerve / Trapezius palsy

- iatrogenic (lymph node biopsy)

- stab wound

 

B.  Long thoracic nerve /  Serratus anterior palsy

- iatrogenic (mastectomy)

- trauma

- repetitive microtrauma / swimming

 

C.  Dorsal scapular nerve / Rhomboids palsy (rare)

 

2.  Osseous

 

Osteochondromas

Fracture Malunions

 

3.  Soft Tissue

 

Muscular origin

- traumatic ruptures of Serratus Anterior

- iatrogenic / thoracotomy

 

Secondary            

 

Due to GHJ articulation disorders

 

A.  Erb’s palsy

- compensatory for IR contracture

 

B.  Deltoid fibrosis

- injury or repeated IM injections

 

C.  Painful conditions

- i.e. RC tear, fracture, impingement

- compensatory

 

Voluntary

 

Rare