Axillary Approach for Pectoralis Major Transfer in the Treatment of Scapular Winging

Transfer of the sternal head of the pectoralis major tendon to the inferior pole of the scapula is a well-known intervention for symptomatic medial scapular winging. Axillary approach has not been well represented in the literature but offers similar functional outcomes with improved cosmetics. In this retrospective review, seven patients with chronic medial scapular winging underwent pectoralis major tendon via axillary approach at a single academic institution. Six of the seven patients had improved function, range of motion, and scapular winging. Transfer of the sternal head of the pectoralis major tendon to the inferior pole of the scapula via an axillary approach is a safe and effective option for scapular winging reconstruction with the advantage of direct visualization of neurovascular structures and improved cosmesis. (Journal of Surgical Orthopaedic Advances 34(2):055-058, 2025)

Key words: scapular winging, pectoralis major transfer, serratus anterior dysfunction, long thoracic nerve dysfunction