AI Article Synopsis

  • Traumatic injuries to the long thoracic nerve can result in winged scapula and shoulder dysfunction, making early and effective treatment crucial yet challenging.
  • A case study of a 32-year-old athlete showed that after surgery for Thoracic Outlet Syndrome, he continued to experience significant weakness and winged scapula, leading to a nerve transfer procedure.
  • The nerve transfer from the thoracodorsal nerve to the injured long thoracic nerve proved successful, restoring shoulder function and significantly reducing chronic pain.

Article Abstract

Background: Traumatic injury to the long thoracic nerve causes paralysis of the serratus muscle, clinically expressed as winged scapula and functional impairment of the shoulder girdle. Treatment varies according to the severity of the injury, with a focus on early intervention for best results; however, the therapeutic approach remains a challenge at present.

Case Description: We present the case of a 32-year-old male patient, athlete, right-handed, presented with bilateral paresis predominantly in the right arm, associated with paresthesia and changes in the coloring of the upper limbs. After being diagnosed with Thoracic Outlet Syndrome and undergoing surgery, vascular symptoms persisted with a significant loss of strength in the right shoulder. Winged scapula was observed and structural lesions were excluded on magnetic resonance imaging. Electromyographic studies confirmed the presumption of traumatic nerve involvement of the long thoracic nerve. Notwithstanding 6 months of physical therapy, there was no improvement, so a nerve transfer from the thoracodorsal nerve to the right long thoracic nerve was chosen. At 12 months, complete resolution of the winged scapula and functional recovery were observed. The patient also experienced a decrease in preoperative pain from 5/10 to 2/10 on the visual analog scale.

Conclusion: Nerve transfer from the thoracodorsal nerve to the long thoracic nerve is a safe and effective technique to treat winged scapula due to long thoracic nerve injury.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152519PMC
http://dx.doi.org/10.25259/SNI_91_2024DOI Listing

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