What is the solution to winged scapula?

Tendon transfer: The most common cause of winged scapula is paralysis of the serratus anterior muscle. This muscle pulls the lower tip of the triangular scapula down and forwards on the rib cage. Winging occurs when the scapula sticks up. If you have not gotten better in 18 months the best treatment is a tendon transfer using half of the pectoral major muscle to substitute for the serratus anterior muscle.

Diagnosis?: There are many and varied reasons for a winged scapula. In our practice the vast majority of patients have scapular winging secondary to shoulder instability so it is important to have a comprehensive evaluation to determine the root cause of the winging before moving ahead with treatment.