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