The winged scapula.

Twenty-five patients with 23 different types of winging of the scapula are described. A simple clinical and etiologic classification of the winged scapula is proposed based on the study of these patients in conjunction with a review of the literature. Winging of the scapula is either static or dynamic. Static winging is due to fixed deformity in the shoulder girdle, spine, or ribs. Dynamic winging is due to a neuromuscular disorder. The great variety of lesions that produce winging of the scapula may be classified anatomically into four types: Type I, nerve; Type II, muscle; Type III, bone; and Type IV, joint. Winging of the scapula is a surprisingly common physical sign, but because it is often asymptomatic it receives little attention. However, symptoms of pain, weakness, or cosmetic deformity may demand attention, and it is hoped that this classification will help in the diagnosis and assessment of these patients.