Surgical management of bilateral scapular winging in a previously healthy 10-year-old boy: A case report.

Introduction: Scapular winging is a pathological condition that occurs due to dysfunction of any scapulothoracic muscles, most commonly the serratus anterior which is innervated by long thoracic nerve.

Case Presentation: Herein, we report a 10-year-old boy presented with bilateral scapular winging for a few months, associated with vague discomfort upon shoulder movements. After taking history and performing physical examination and tests as electromyography, he was diagnosed with idiopathic bilateral scapular winging as there was no obvious cause or risk factor for his bilateral scapular winging.

Discussion: Scapular winging causes decrease strength and range of motion of the shoulder, the usual complain of patients is discomfort or the unpleasant cosmetic appearance of scapular prominence, this condition, if left untreated, can cause various negative consequences on the shoulder joint, detailed history and physical exam reinforced by electromyography are crucial in determining the cause of winging, as it has many causes, initial management can be conservative, but various surgical approaches have been described for more severe cases which compromise shoulder function, choice of the surgical approach depends on the underlying cause and overall clinical picture of the patient.

Conclusion: bilateral scapular winging is rare condition, only 26th cases were reported in literature, it occurs due to multiple causes, treatment can be conservative at early stages, but surgical option should be considered when shoulder function and strength become compromised.