Hey, you want to get controversial? This isn't - because nobody thought enough about it, yet, to have an objection.

There is a tendency to assume that scoliosis scapular winging is from the scapula (shoulder blade) sitting on the apex of deformed backward prominent ribs.

Makes sense. wing-1a

But, not computer modeling sense.




Let's take a closer look. Here we see the right scapula winging up and maybe it is sitting on the peak of the  rotated ribs.







Here's another view. Still looks like it may be sitting on the peak of the rotated ribs.





Mmmmm, is that really  'ON' the rotated ribs.?


Doesn't look that way from here.

















Whoops. Is that the CLAVICLE pressing on the ribs . . . unable to span the differential of the ribs rotation?  . . . pulling the scapula around the front and acting as a fulcrum?





Kidding. Look!
Of course it is.


So, thoracoplasty folks, beware, lowering the apical ribs from behind might not accomplish a whole bunch without considering this detail.