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Primary Scapular Winging Neurologic Origin Trapezius

Scapular winging, one of the more common scapulothoracic disorders, is caused by a number of pathologic conditions. It can be classified as primary, secondary, or voluntary. Primary scapular winging may be due to neurologic injury, pathologic changes in the bone, or periscapular soft-tissue abnormalities. Secondary scapular winging occurs as a result of glenohumeral and subacromial conditions and resolves after the primary pathologic condition has been addressed. Voluntary scapular winging is not caused by an anatomic disorder and may be associated with underlying psychological issues. The evaluation and treatment of these three types are discussed. J Am Acad Orthop Surg 1995;3:319-325 Scapular winging is one of the most common abnormalities of the scapulothoracic articulation. Winging may be described as primary, secondary, or voluntary (Table 1). Primary scapular winging is caused by anatomic disorders that directly affect the scapulothoracic articulation. Secondary scapular winging usually accompanies some glenohumeral disorder and should resolve once that disorder has been addressed. Voluntary winging may have psychological overtones and is quite rare.