Cases of damage to the long thoracic nerve result in a phenomenon known as winged scapula, which is due to paralysis of the serratus anterior or trapezius muscles.
Is winged scapula normal for children?
A winged scapula is considered normal posture in young children, but not older children and adults.
What nerve is affected with winged scapula?
The most common cause of scapular winging is paralysis of the serratus anterior muscle due to the injury of the long thoracic nerve. Dorsal scapular neuropathy may result in abnormal motion of the shoulder joint with scapular winging.
Why does a long thoracic nerve palsy cause scapular winging?
Background. In neurological diseases, winging of the scapula occurs because of serratus anterior muscle dysfunction due to long thoracic nerve palsy, or trapezius muscle dysfunction due to accessory nerve palsy. Several sports can cause long thoracic nerve palsy, including archery and tennis.
Why is the long thoracic nerve susceptible to injury?
Due to its long, relatively superficial course, the long thoracic nerve is susceptible to injury, either through direct trauma or stretch. Mechanisms of injury include: nerve lesions. various sports injuries, typically occurring from a blow to the ribs underneath an outstretched arm.
Is the long thoracic nerve a peripheral nerve?
Long thoracic nerve injury is another peripheral-nerve shoulder injury seen in football players and can be quite disabling. This nerve innervates the serratus anterior muscle, which is important for scapular stabilization, protraction, and rotation during shoulder abduction.
Is winged scapula a disability?
Irrespective of the cause of winging of the scapula, the condition is disabling and can affect the function of the ipsilateral shoulder and arm. Also, winging of the scapula also leads to significant cosmetic deformity.
What does scapular winging indicate?
If the winged scapula is the result of nerve damage, it can cause weakness in the muscles of your neck, shoulders, and arms. That weakness can make lifting, pulling, and pushing heavy objects hard. Scapular winging often affects your ability to raise your arm above your shoulder.
How do you know if you have long thoracic nerve damage?
Typical signs and symptoms are as follows: Observable scapular winging at rest (usually inferior border only), with overhead movements, or resisted wall push-ups/push-ups whereby the entire scapula demonstrates winging (see figure 2). Pain around the base of the neck, deltoid, and scapula.
How do you test for long thoracic nerve damage?
The test for identifying a long thoracic nerve injury is the ‘serratus wall test’. The patient is asked to face a wall, standing about two feet from the wall and then push against the wall with flat palms at waist level.
What is long thoracic nerve palsy?
Long thoracic nerve palsy is a shoulder condition characterized by pain and loss of shoulder movement owing to damage or injury of the long thoracic nerve. This nerve evolves from the roots of neck vertebrae (C5-C7) and supplies to serratus anterior muscle that retains the scapula bone to the chest wall.
What is long thoracic nerve injury?
What causes winging of the scapula in young children?
Post-traumatic winging of scapula in young children is rare. It is more commonly reported in young athletes. Stability of the scapula is secured mainly through two muscles, the serratus anterior and the trapezius. Therefore, dysfunction of either of these muscles and more commonly serratus anterior can cause winging of the scapula.
How is degree of winging measured in thoracic nerve entrapment?
The degree of winging can be quantified by angle of posterior projection of the inferior scapular border from the chest wall at the point of maximal winging. Most patients with long thoracic nerve injury also show weakness of the deltoid and biceps muscles on examination.
How do you treat a winged scapula?
For surgeons, awareness of potential variations of the long thoracic nerve and the accessory nerve can decrease the incidence of winged scapula with an iatrogenic cause [7-10]. Several surgical procedures have been used in the past to treat winged scapula.
Why is my scapula bent at the top?
Winging of the scapula due to long thoracic nerve (LTN) injury is a fairly common diagnosis and should be treated as a significant functional problem. The LTN originates from the cervical 5,6 and 7 nerve roots and innervates the serratus anterior muscle. The main job of the serratus anterior muscle is to hold…
