Winged Scapula - Overview
Winging scapula is a sort of a shoulder injury in which the scapula sticks out at the back. This 'sticking out' of the scapula is particularly visible if one lifts his/ her arm up or tries to push against the wall. Patients usually complain about the pressure in the affected bone from the back while sitting on the chair. The symptoms of this condition are noticeable winging of the scapula, pain in the affected bone, limited shoulder elevation and difficulty while lifting heavy objects.
This condition is connected with the damage or a contusion of the long thoracic nerve of the shoulder and consequent weakness of the serratus anterior muscle. Damage or injury of the previously mentioned nerve causes paralysis of the serratus anterior muscle. The muscle cannot control the bone and the scapula elevates. Damage to the nerve is most commonly caused by a contusion or blunt trauma of the shoulder. It may also affect people lifting heavy objects. Furthermore, the injury occurs due to repetitive throwing, traction of the neck and in some cases develops as a consequence of a viral infection.
Surgery for Winged Scapula
The surgeon performs several tests and examinations in order to assess the extent of damage to the long thoracic nerve. After that he plans the treatment which basically consists of physiotherapy and surgery.
The goal of physiotherapy is to re-educate the serratus anterior muscle. This can be achieved only if the damage to the nerve is mild. This treatment lasts approximately 6 to 12 months.
If nerve conduction studies confirm significant damage to the long thoracic nerve the patient undergoes surgery called a long thoracic nerve decompression. The goal of the surgery is to help the affected nerve recover. This is a highly successful procedure with excellent results. The surgery is performed under general anesthesia and includes a small incision line which allows the surgeon to reach for and decompress the affected nerve.
This surgery carries several risks related to anesthesia and infections and in some cases there is a chance of postoperative stiffness/ pain around the shoulder and damage to nerves and blood vessels around the shoulder.
After the surgery patients regularly undergo rehabilitation in a form of physical therapy. They are taught specific exercises which are supposed to be performed on regular bases. After the surgery patients are supposed to wear a sling for a certain period of time. If there are problems related to pain in the operated area patients are usually prescribed painkillers.