PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■胸长神经的创伤性损伤会导致锯齿肌麻痹，临床上表现为有翼肩胛骨和肩带功能损害。治疗方法因损伤的严重程度而异,注重早期干预以获得最佳效果；然而，目前，治疗方法仍然是一个挑战。
■我们介绍了一个32岁的男性患者，运动员,右撇子,主要在右臂出现双侧轻瘫，与感觉异常和上肢颜色的变化有关。在被诊断为胸腔出口综合症并接受手术后，血管症状持续存在，右肩力量明显丧失。观察到翼状肩胛骨，磁共振成像排除了结构病变。肌电图研究证实了长胸神经的创伤性神经受累的推定。尽管有6个月的物理治疗，没有任何改善,所以选择了从胸背神经到右胸长神经的神经转移。12个月时,观察到翼状肩胛骨的完全消退和功能恢复。在视觉模拟量表上，患者的术前疼痛也从5/10降低到2/10。
■从胸背神经到长胸神经的神经转移是一种安全有效的技术，可治疗因长胸神经损伤而引起的有翼肩胛骨。
■我们介绍了一个32岁的男性患者，运动员,右撇子,主要在右臂出现双侧轻瘫，与感觉异常和上肢颜色的变化有关。在被诊断为胸腔出口综合症并接受手术后，血管症状持续存在，右肩力量明显丧失。观察到翼状肩胛骨，磁共振成像排除了结构病变。肌电图研究证实了长胸神经的创伤性神经受累的推定。尽管有6个月的物理治疗，没有任何改善,所以选择了从胸背神经到右胸长神经的神经转移。12个月时,观察到翼状肩胛骨的完全消退和功能恢复。在视觉模拟量表上，患者的术前疼痛也从5/10降低到2/10。
■从胸背神经到长胸神经的神经转移是一种安全有效的技术，可治疗因长胸神经损伤而引起的有翼肩胛骨。
