Combined Serratus Anterior Plication and Pectoralis Minor Release Improves Clinical Outcomes in Refractory Scapular Dyskinesis with Neurological Involvement

The SAPPER technique is a safe and effective modification of traditional scapulopexy. It enhances scapular positioning and serratus function without the need for rib-based fixation, potentially minimizing complications. This approach significantly improves pain, function, and mobility in patients with refractory scapular dyskinesis and associated neurogenic thoracic outlet syndrome.