Winging of the scapula.

Horrigan JM, Coughlin  SP, Lazar M.   Journal of the Neuromusculoskeletal System 1994, Volume 2, Number 1:28-32.

Traumatic scapular winging is most often associated with lesions of the long thoracic nerve or spinal accessory nerve.  Two similar cases of scapular winging associated with traumatic anterior glenohumeral instability in elite professional hockey players are presented.  One case was found to have long thoracic neuropathy, and the other case had no neurologic deficit by electrodiagnostic evaluation.  A literature search revealed only two references of scapular secondary to glenohumeral injury.  The importance of performing a complete examination of the shoulder is emphasized because of the similar presentation of scapular winging due to separate etiologies.  Decreased mechanical function of the subscapularis muscle is suggested as an additional etiology of winging of the scapula.