Outcomes of tendon transfers for scapular winging in young military athletes

Abstract

Background: The partial pectoralis major transfer for the treatment of serratus anterior deficiency and modified Eden-Lange/Triple Tendon Transfer for trapezius deficiency result in improvement in pain and shoulder function. However, athletic function following these procedures is unknown. The purpose of this study is to determine the outcomes and return to military duty and athletic tasks following partial pectoralis major transfer and Tripler Tendon Transfer. Methods: A retrospective review of prospectively gathered data was performed for all patients surgically treated for medial and lateral scapular winging at two military medical centers. Preoperative patient-reported outcomes collected included the Single Assessment Numeric Evaluation (SANE), Visual Analog Scale (VAS), and American Shoulder and Elbow Surgeons (ASES). Patients were excluded if they had less than 1 year follow-up, no postoperative patient-reported outcomes or return to military duty data. Results: Eleven patients were surgically treated for scapular winging, 7 patients for serratus anterior deficiency and 4 patients for trapezius deficiency and were available for follow-up at a mean of 28 months. The mean preoperative outcome scores were SANE 40.9%, VAS 4.4 and ASES 54.4. Significant improvement in SANE 77.4% (P = .001), VAS 1.8 (P = .017) and ASES 75.7 (P = .008) was identified. Five of the 9 (55.6%) active-duty service members were able to meet their fitness requirements and remain on active-duty status. Conclusion: The split pectoralis major transfer for serratus anterior deficiency and the Triple Tendon Transfer for trapezius deficiency are excellent treatment options in patients who have high physical demands.

Keywords

• Scapular winging
• Muscle tendon transfer
• Scapulothoracic abnormal motion (STAM)
• Military
• Triple tendon transfer
• Pectoralis transfer