Angel Wing and Frog Leg: Causes, Genetics, and Treatment Options

Angel Wing + Frog Limb

Dear Dr.
Su,
I would like to ask about the causes of right deltoid atrophy (winged scapula) and frog leg deformity.
Is there a genetic component to these conditions? When I was four years old, I underwent surgery on my right arm.
The doctor mentioned that a tendon was constricted, and after the surgery, it was still unsuccessful due to the underdeveloped medical technology at that time, or perhaps because these conditions were not commonly recognized back then.
If I wish to seek treatment now, is it still possible? If treatment is not an option, are there any potential complications that could arise?
Additionally, I can squat completely with my heels on the ground, but when standing and bending my knees, I hear a popping sound in my hip joint, and I feel movement in the entire joint, which allows me to bend fully.
Furthermore, I am unable to cross my legs while sitting, like most women do when wearing a skirt.
Does this also qualify as a form of frog leg deformity? Is there a possibility for treatment in this case? If left untreated, could there be any associated complications?
Thank you.

RUBY, 20~29 year old female. Ask Date: 2005/04/26

Dr. Su Yiren reply Orthopedics

Hello RUBY! The deltoid muscle, like the gluteus maximus, has many patients with contractures.
In severe cases, the upper limbs cannot be brought close to the body, and walking resembles that of a traditional Taiwanese performer.
Therefore, surgery to release the muscles is necessary.
You mentioned having shoulder surgery at the age of 4; the subsequent conditions may not be straightforward and could be associated with other neurological disorders, which might explain the severe contractures at such a young age.
Additionally, the sounds produced during hip flexion are often caused by the tensor fascia lata.
This fascia interacts with the greater trochanter of the femur, leading to symptoms.
This is somewhat related to snapping hip syndrome, but individuals without snapping hip syndrome can also experience similar symptoms.
Dr.
Su Yi-Ren, Puzih Hospital.

Reply Date: 2005/04/26

More Info

Understanding conditions like Angel Wing (Scapular Winging) and Frog Leg (often referred to in the context of lower limb deformities) involves a multifaceted approach that includes examining their causes, genetic implications, and available treatment options.

Angel Wing (Scapular Winging) is characterized by the protrusion of the scapula away from the back, resembling a wing. This condition can arise from various causes, including:
1. Nerve Injury: The most common cause is injury to the long thoracic nerve, which innervates the serratus anterior muscle. Damage to this nerve can occur due to trauma, surgical procedures, or even repetitive strain injuries.

2. Muscle Weakness: Conditions that lead to muscle atrophy or weakness, such as muscular dystrophies or other neuromuscular disorders, can also result in scapular winging.

3. Structural Abnormalities: Congenital conditions or structural deformities of the shoulder girdle can contribute to this condition.

As for genetics, while some forms of scapular winging may have a hereditary component, particularly those associated with muscular dystrophies, most cases are acquired rather than inherited. If your condition is related to a previous surgical intervention or trauma, it is less likely to be genetic.

Regarding treatment, early intervention is crucial. Physical therapy focusing on strengthening the shoulder girdle muscles can be beneficial. In some cases, surgical options may be considered, especially if there is a significant nerve injury or structural issue. Consulting with an orthopedic specialist or a neuromuscular expert would provide tailored options based on your specific situation.

Frog Leg Deformity typically refers to a condition where the legs are positioned in a way that resembles a frog's legs, often due to hip joint issues or muscle imbalances. The causes can include:
1. Developmental Dysplasia: Abnormal development of the hip joint can lead to altered leg positioning.

2. Neuromuscular Disorders: Conditions affecting muscle tone and control can result in abnormal limb positioning.

3. Injury or Surgery: Previous injuries or surgical interventions, like the one you mentioned at age four, can also contribute to this condition.

In terms of genetics, similar to scapular winging, some forms of limb deformities can have a genetic basis, particularly those associated with syndromes or congenital conditions. However, many cases are acquired due to environmental factors or injuries.

Your ability to squat down without lifting your heels off the ground suggests a certain degree of flexibility and joint function, but the clicking sound in your hip joint may indicate underlying issues such as joint instability or labral tears. It is essential to have this evaluated by a healthcare professional, as persistent clicking or instability can lead to further joint problems over time.

Regarding your inability to cross your legs while sitting, this could be related to muscle tightness, joint restrictions, or structural abnormalities in the hips or knees. While this may not be classified strictly as "Frog Leg," it indicates a limitation in normal range of motion.

Treatment Options: For both conditions, physical therapy focusing on strengthening and flexibility exercises can be beneficial. If conservative measures do not yield improvement, surgical options may be considered, especially if there is significant functional impairment or pain.

Potential Complications: If left untreated, both conditions can lead to further musculoskeletal issues, including chronic pain, joint degeneration, and decreased functional capacity. Therefore, seeking a comprehensive evaluation from a specialist in orthopedics or physical medicine and rehabilitation is advisable.

In conclusion, while both Angel Wing and Frog Leg conditions can be complex, understanding their causes, potential genetic links, and treatment options can help guide you toward effective management strategies. Early intervention and a tailored rehabilitation program can significantly improve outcomes and quality of life.

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