Physiotherapy Proposal for the Emergency Service in Patients with Winged Scapula associated to Axillary Limphadenectomy

Abstract

A winged scapula is one of the many complications arising from surgical treatment with partial or total excision of the breast associated with axillary dissection (axillary lymph node dissection). This exhaustion is almost always present, as is to be an important area of metastatic spread. During the surgery, partial (neuropraxy) or total lesions (neurotmesis) of the long thoracic nerve may occur, leading to a winged scapula. Although it is not often described in literature, ranging between 1.5% and 12.6%, it is quite usual in the daily practice of physiotherapy service. Damage to this nerve results in the destabilization of the whole scapulohumeral structure and may bring consequences: postural changes, decreased range of motion in the ipsilateral shoulder and pain in the joints and in the prescapular region. This work aims to review the literature to propose a physiotherapy protocol for an early treatment of patients with winged scapula, in order to minimize or prevent complications, thus, providing patients with a better quality of life.