In some serious cases, the ability to perform activities of daily living such as changing one's clothes and washing one's hair may be hindered.
The name of this condition comes from its appearance, a wing-like resemblance, due to the medial border of the scapula sticking straight out from the back.
Scapular winging has been observed to disrupt scapulohumeral rhythm, contributing to decreased flexion and abduction of the upper extremity, as well as a loss in power and the source of considerable pain.
When the serratus anterior contracts, upward rotation, abduction, and weak elevation of the scapula occurs, allowing the arm to be raised above the head.
Serratus anterior palsy is a dysfunction that is characteristic of traumatic, non-traumatic, and idiopathic injury to the long thoracic nerve.
Severe atrophy of the trapezius is seen with accidental damage to the spinal accessory nerve during lymph node biopsy of the neck.
[1] Non-traumatic induced injury to the long thoracic nerve includes, but is not limited to, causes such as viral illness (e.g. influenza, tonsillitis-bronchitis, polio), allergic-drug reactions, drug overdose, toxic exposure (e.g. herbicides, tetanus), C7 radiculopathy, and coarctation of the aorta.
[1][8] In addition to history and exam, it has been recommended to perform projectional radiography of the neck, chest, shoulder, and thoracic inlet to rule out structural abnormalities such as malunited or greenstick fractures.
[1] Computed tomography (CT) or magnetic resonance imaging (MRI) are rarely indicated, but may be useful to rule out certain diagnoses if suspected, such as neurofibromatosis-related injury, intervertebral disc disorder, radiculopathy, and tumors.
Strength training, particularly of the serratus anterior, may be recommended as this muscle is responsible for holding the medial scapula close to the rib cage.
[3][10] Even though scapulothoracic fusion has been shown to have successful outcomes, complications were present in over 40% of the 130 patients observed by Kord et al.[12] A winged scapula due to serratus anterior palsy is rare.