Dr. Nath's response to the Winging question

[Tessie258]

Thanks for all the help Francine and Dr. Nath.
I have a question and I may sound ignorant in the question but if you never ask then you never know.

By winging do you mean that the scapula sticks out more or do you mean the whole scapula moves like in a frozen position with the shoulder?

The reason I ask is because I remember that, I who have no injury, as a kid had very pronounced scapular "wings" and I grew out of it. I was VERY skinny as a child(you wouldn't know it now!!!) I was also a pretty weak kid.

Jameson used to have a thing his scapular did on his injured side that looked the same as scapular sticking out but he also has a kind of fused movement to his shoulder and scapular. He doesn't stick out anymore but he still has the "winging or fusion". Let me see if I can describe this better.(I'm going to describe a right side) If you face your childs back and place your left hand on the childs right scapula and use your right hand to raise your childs arm above their head the scapula should stay put and the shoulder move separately. In my son's case his whole scapula moves as if he is attached or fused.
The reason I'm asking this is because I wonder if people really mean winging or if they mean a pronounced scapula???? I believe there is a difference????
Someone help me out here.
T.

[Clint]

The scapula actually does move significantly in the elevation of the arm. In fact, it is this movement of the scapula which allows the arm to elevate past 90 degrees. If you compare the shoulder to the hip (another ball-and-socket joint), the shoulder has far greater range of motion because the "socket" of the joint (the scapula) moves as well. The scapula can move up, down, forward, and backwards along the wall of the chest.

[Kristie]

Kathleen,
What I am getting at is how does it feel? Is there any pain assoicated with it? I guess at this point I want to try and see if I can help us avoid the pain. I am not so concerned with how it looks however in the long run of things I would prefer that he not have any winging (and not be dislocated either- which is of course possible- I am not dislocated and I don't wing). Anyway... I want his affected side to be as normal as possible.
Thanks,
Kristie

[Kristie]

Tessie,
I understand what you are refering to.. here is a link to a photo of what is considered a winged scapula:
http://groups.msn.com/TheWingedScapula/ ... PhotoID=18
The scapula sticks out more. I would like to avoid this with my son as much as possible. But I think even the fusion type movement you described is on the whole undesireable. I know that I am working for the moon but my goal is to help Ian have as normal of movement as possible... it might not happen but it is my goal.
Kristie

[admin]

My son does not have a bpi but he has winging on one side, and posterior dislocation, it is a result of injury to the long thoracic nerve and his serratus muscle is reduced by 50 percent. this was caused by a car accident. The winging does not cause him pain although he does have pain some days. What is disabling for him is the dislocation/instability of his shoulder. and just recently has been experiencing neck pain/stiffness. Unfortunately they dont want to repair the dislocation because of the winging they keep hoping for a spontaneous recovery of the winging. but he has been a year now. Where is Dr. Nath located he sounds like the most knowledgeable person i have heard on this subject. Please forward any information on how to contact him for appointments. Also do you know if he does muscle transfer surgeries?

[cybermomx4]

This was under the Medical resources page on the site. Dr. Nath is a very knowledgeable man and a wonderful person let alone a GREAT doctor. My son has had two surgeries by him...my son is 4 1/2 with a robpi. Dr Nath will answer your e-mail and his secretarys name is Brenda....
Approved contact information:
Texas Childrens Hospital
6621 Fannin
Houston, TX 77030
website: http://www.texaschildrenshospital.org/C ... s/Main.htm

Initial contact and Primary Surgery: Lisa Davis
phone: 1.800.364.5437, ext. 2.3290
fax: 832.825.4812

This is where you should probably start.....
Physician Contact: Rahul Nath, MD
Dr. Nath's email: rnath@bcm.tmc.edu

Secondary surgery contact: Lisa Thompson
Lisa Thompson's email: lisat@bcm.tmc.edu
Lisa Thompson's phone number: 713.798.8215.

I do not have Dr. Nath's phone number but Lisa Davis can get it for you !

[cybermomx4]

Yes, he does muscle transfer surgeries !

[patpxc]

The way I figure it, is a mom would only see the child she loves. Like having a kid with big ears or buck teeth . a face only a mother could love-- I guess that's true. She sees the inside--into the soul--not the broken wing. Does that make sense??? Pat

[admin]

Denise, the doctor you are talking about has stated that he has not seen dislocation with trauma injuries like your son's. This may mean he hasn't seen many trauma patients, because I have read posts from many of the trauma adults that they do have dislocation-make sure the surgeon you choose is very experienced with this kind of injury rather than birth injury, which is what this doctor specialises in.

[stateilx3]

Denise,
Please call Dr. Nath, he does work on trauma patients also......not just birth injuries. he is honest and trustworthy.....please give him and your son a chance !