A clinical and electrophysiological study of neurogenically induced winging of the scapula.

Four cases of neurogenically induced winging of the scapula are described. Systematic clinical evaluation enabled the affected nerve or nerves to be defined in each case, particular attention being directed to the presence or absence of deformity at rest, the direction of rotation of the winging scapula, and the movement of the arm that produced maximal scapular winging. EMG studies were performed on all 4 cases and serial spinal accessory nerve conduction studies on the 2 patients with involvement of this nerve. Both techniques proved useful adjuncts to clinical evaluation and provided confirmatory diagnostic information. The accessory nerve conduction studies were of further value in assessing the extent and type of neural damage, the rate of recovery and the prognosis.