J Korean Med Sci.  2006 Jun;21(3):581-584. 10.3346/jkms.2006.21.3.581.

Winged Scapula Caused by Rhomboideus and Trapezius Muscles Rupture Associated with Repetitive Minor Trauma: A Case Report

• Lee SG
• Kim JH
• Lee SY
• Choi IS
• Moon ES

• KMID: 1778450
• DOI: http://doi.org/10.3346/jkms.2006.21.3.581

Abstract

We experienced a rare case of winged scapula that was caused by the rupture of the rhomboideus major and the lower trapezius muscles without any nerve injury in a 12 yr old female after she had carried a heavy backpack. Electrodiagnostic study revealed that the onset latencies, amplitudes and conduction velocities were normal in the long thoracic nerve, the spinal accessory nerve and the dorsal scapular nerve. The needle EMG findings were normal as well. An explorative operation was performed and the rupture of the rhomboideus major and lower trapezius muscles was detected. Direct surgical repair of the ruptured muscle was carried out and the deformity was corrected. The anatomical and functional restoration was satisfactorily accomplished.

Keyword

Scapula; Muscle, Skeletal; Wounds and Injuries; Rhomboideus Muscle; Trapezius Muscle Shoulder

MeSH Terms

Weight Lifting/injuries
Thoracic Nerves/*injuries
Scapula/anatomy & histology/*physiopathology
Rupture
Neurons/metabolism
Muscle, Skeletal/*injuries/innervation/*pathology
Humans
Female
Electromyography/*methods
Child

Figure

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  Fig. 1 Winged scapula caused by the rupture of the right rhomboideus major and lower trapezius muscles: (A) shows the lateral deviation and upward rotation of the inferior angle of the right scapula, as examined with the patient in an erect neutral posture. (B) shows no detectable asymmetry on shoulder abduction. (C) shows a more prominent winging of the right scapula on shoulder flexion.

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  Fig. 2 (A) The intraoperative findings revealed the rupture of some portions of the right rhomboideus major and lower trapezius muscles (white arrow). (B) Postoperative illustration of the rhomboideus major and lower trapezius repair and reefing. (C) Postoperative findings showed restoration of scapular symmetry with the patient in a neutral erect posture.

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