Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2019; 10(1): 33-44
Published online Jan 18, 2019. doi: 10.5312/wjo.v10.i1.33
Contralateral trapezius transfer to treat scapular winging: A case report and review of literature
Juan José Gil-Álvarez, Pablo García-Parra, Manuel Anaya-Rojas, María del Pilar Martínez-Fuentes
Juan José Gil-Álvarez, Pablo García-Parra, Manuel Anaya-Rojas, Department of Orthopedics and Traumatology, Hospital Universitario Virgen del Rocío, Sevilla 41013, Spain
María del Pilar Martínez-Fuentes, Department of Rehabilitation, Hospital Universitario Virgen del Rocío, Sevilla 41013, Spain
Author contributions: All authors contributed equally to this paper in regards to conception and structure of this case report, data collection, literature review, and drafting and critical revisions of the manuscript; all authors gave approval of the final version.
Supported by Fundación Pública Andaluza para la Gestión de la investigación en Salud de Sevilla; “FISEVI”.
Informed consent statement: Written informed consent was given by the participant before the beginning of the study.
Institutional review board statement: The Institutional Review Board (IRB) of Hospital Universitario Virgen del Rocío gave approval for the study, No. JGA-TCEA-2017.
Conflict-of-interest statement: The authors of the study have no potential conflicts of interest to declare.
CARE Checklist (2016) statement: The guidelines of the “CARE Checklist - 2016: Information for writing a case report” have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Juan José Gil-Álvarez, MD, PhD, Associate Professor, Department of Orthopedics and Traumatology, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, Sevilla 41013, Spain. jgilalvarez@gmail.com
Telephone: +34-95-5012000
Received: September 12, 2018
Peer-review started: September 12, 2018
First decision: October 19, 2018
Revised: November 17, 2018
Accepted: December 17, 2018
Article in press: December 17, 2018
Published online: January 18, 2019
Abstract
BACKGROUND

No dynamic technique, such as tendon transfer, has been described for scapular winging due to levator scapulae or rhomboid major and minor palsies resulting from an isolated dorsal scapular nerve injury. Thus, we evaluated how the contralateral trapezius compound osteomuscular flap transfer would work in stabilizing lateral scapular winging, and the case is reported here. A literature review was also conducted, and articles relevant to the case are presented.

CASE SUMMARY

A 37-year-old male patient who had sustained an isolated dorsal scapular nerve injury underwent reconstructive surgery using the contralateral trapezius compound osteomuscular flap transfer technique to treat scapular winging and the consequent pain, and to restore function from the shoulder impairment. As a result, the involved shoulder showed an improved Constant-Murley score, from 19.5% to 81.88%.

CONCLUSION

Contralateral trapezius osteomuscular flap transfer succeeded in stabilizing scapular winging in this case, improving shoulder function and affording pain relief.

Keywords: Trapezoid muscle, Osteomuscular flap, Scapular winging, Rhomboid muscles, Nerve paralysis, Dorsal scapular nerve, Case report

Core tip: This report describes a case of scapular winging as a result of dorsal scapular nerve injury. Only few cases of winged scapula due to rhomboid paralysis are reported in the literature. Although scapular winging can seriously impair shoulder function, no dynamic techniques have been described to treat this condition. This case reveals that contralateral trapezius compound osteomuscular flap transfer can successfully stabilize lateral scapular winging due to a dorsal scapular nerve injury, while improving shoulder function and affording pain relief.