The Case Shoulder & Elbow Service

CONTACT US
Gobezie, Reuben, MD
Assistant Professor,
Department of Orthopaedic Surgery
Case Western Reserve University School of Medicine

Phone Numbers
Appointments: (216) 844-7200
Office Number: (216) 844-7093
FAX Number: (216) 844-5970
Email: reuben.gobezie@uhhospitals.org

Office Locations
UHHS Chagrin Highlands Medical Center
3909 Orange Place
Orange Village, OH 44122
County: Cuyahoga-East
Phone Number: (216) 844-7093
Fax Number: (216) 844-5970
Directions To Our Office

University Suburban Health Center
1611 S. Green Road
South Euclid, OH 44121
Phone Number: (216) 844-7093
Fax Number: (216) 844-5970
Directions To Our Office

University Hospitals
Westlake Campus
960 Clague Road
Westlake, OH
Directions To Our Office

During the physical examination, winging may or may not be obvious to the physician. . If weakness of the scapular muscles is not severe the condition can sometimes be less noticeable.

When the serratus anterior functions improperly, the scapula moves backward and wings when the arm is raised in front of the body into flexion.
If the trapezius muscle functions improperly, the scapula moves toward the opposite side and wings when the patient tries to raise the arm out to the side

Diagnostic Tests
The most important diagnostic test for scapular winging is called an electromyographic and nerve conduction study (EMG and NCS). This special test measures the electrical impulses coming down the nerves to the scapular muscles. Nerve injuries which cause winging prevent normal conduction of electrical impulses to the muscles, causing them to malfunction. When the serratus anterior is involved, the long thoracic nerve may be paralyzed. When the trapezius is involved, the spinal accessory nerve is damaged.