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Evaluation and treatment of the winged scapula.

Winging of the scapula is often associated with palsy of the serratus anterior muscle, but can be due to numerous pathologic processes. Often representing more than just a cosmetic deformity of the shoulder, it can lead to significant pain and functional impairment. Winging can be due to disease in the nerves, muscles, bones, and joints in the periscapular area and may be either a static or dynamic deformity. Treatment of the winged scapula depends on the severity of the patient's complaints, and the exact treatment required is determined by the underlying pathologic process. A systematic approach to the winged scapula is essential to ascertain the underlying cause and successfully manage this deformity of the shoulder girdle.