Published online Jan 18, 2019. doi: 10.5312/wjo.v10.i1.33
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
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.
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%.
Contralateral trapezius osteomuscular flap transfer succeeded in stabilizing scapular winging in this case, improving shoulder function and affording pain relief.
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.