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Winging of the scapula has been reported as early as 1825,1 Since then numerous cases of serratus anterior dysfunction have been published. The vast majority of these reports attribute medial scapular winging to a long thoracic neuropraxic lesion. Rarely has scapular winging been attributed to muscular injury. The first report by Fitchet2 lacked electromyographic investigation of the long thoracic nerve and presumed the etiology to be a muscular disruption based on history and physical. Hayes and Zehr3 reported a traumatic avulsion of the interior scapula resulting in medial scapular winging that was surgically repaired 9 months later. We present a case of scapular winging in a patient with normal serial electromyograms.
CASE REPORT
A 34-year-old healthy woman attending an aerobics class noticed the sudden onset of pain in the right scapular region. This was heralded by a rather noticeable pop. At the time, she had her elbows' and shoulders flexed 90°, elbows opposed, and was externally rotating her shoulders; There were no hand-held weights being used. Following this episode, she had an ache for a few days, but otherwise was painless. Two months after injury; she sought treatment for right shoulder weakness arid poor motion. At no time did she experience any neck pain, paresthesias, or numbness. Prior to this injury she had no history of infection or shoulder trauma.
Her examination was completely unremarkable with regard to cervical spine range of motion. Spurting's maneuver, passive shoulder motion, reflexes, sensation, and moten- strength except for serratus anterior function which was weak. Active elevation of the ami...