Outcome of transfer of the sternal head of the pectoralis major with its bone insertion to the scapula to manage scapular winging

• Published in: Journal of shoulder and elbow surgery 2015-05, Vol.24 (5), p.733-740
• Main Authors: Elhassan, Bassem T., MD, Wagner, Eric R., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Muscle, Skeletal - injuries; Muscle, Skeletal - physiopathology; Orthopedics; Pectoralis major transfer; Pectoralis Muscles - surgery; Peripheral Nerve Injuries - complications; Radiography; Range of Motion, Articular; Scapula - diagnostic imaging; Scapula - surgery; scapular winging; Shoulder Joint - physiopathology; Shoulder Joint - surgery; Shoulder Pain - etiology; Shoulder Pain - surgery; Sternum - surgery; Tendon Transfer - methods; Thoracic Nerves - injuries; Wound Healing; Young Adult
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2014.08.022

Hypothesis The purpose of this study was to evaluate the outcome of transfer of the sternal head of the pectoralis major with its bone insertion to the inferior pole of the scapula for symptomatic winging. Methods Our study included 51 patients with serratus anterior dysfunction secondary to chronic muscle or long thoracic nerve injury. Indications included pain, scapular winging, and limited active motion after failed conservative management. All patients underwent transfer of the sternal head of the pectoralis major with its bone insertion to the scapular inferior pole. Computed tomography scan was performed at 3 months postoperatively to evaluate bone healing. Results At an average follow-up of 29 months (range, 12-46 months), 45 patients had complete and 6 patients had partial resolution of the scapular winging. Patients had significant improvements in their shoulder abduction, forward flexion, and pain levels ( P