scholarly journals A Patient with Clavicle Fracture and Recurrent Scapular Winging with Spontaneous Resolutions

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Kendra E. Keenan ◽  
John G. Skedros
Keyword(s):  
Clavicle Fracture ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Scapular Winging ◽  
Inflammatory Neuropathy ◽  
Fracture Nonunion ◽  
Joint Separation ◽  
Surgical Manipulation ◽  
Acromioclavicular Joint Separation

Injury to the long thoracic nerve with resulting serratus anterior palsy is a typical cause of medial scapular winging. We report a case of a 70-year-old female with scapular winging in the setting of a mildly comminuted midshaft clavicle fracture. The winging persisted for three months after the fracture, which became a nonunion. The winging spontaneously resolved prior to open reduction and internal fixation of the nonunion. The winging recurred after this surgery. The recurrence was attributed to transient irritation and/or inflammatory neuropathy of the brachial plexus caused by the surgical manipulation. This second episode of winging again spontaneously resolved. There are few reported cases of scapular winging in the setting of a clavicle fracture and only one case of recurrent scapular winging. In that case, which was in the setting of an acromioclavicular joint separation, the second episode of winging required long-term use of a brace. By contrast, our patient did not require bracing because the recurrent winging spontaneously resolved, making this a novel case. This case is important because it illustrates that recurrent scapular winging can occur, and spontaneously resolve, in the setting of a mid-shaft clavicle fracture after subsequent reconstruction of a fracture nonunion.

scholarly journals Initial Electromyography Fails to Predict Long-Term Outcome of Isolated Serratus Palsy

2018 ◽  
Vol 107 (4) ◽  
pp. 356-359
Author(s):  
M. Vastamäki ◽  
H. Vastamäki ◽  
V. Pikkarainen ◽  
L. Ristolainen
Keyword(s):  
Nerve Injuries ◽  
Subjective Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Thoracic Nerve ◽  
Scapular Winging ◽  
Partial Denervation ◽  
Better Than

Background and Aims: The course of isolated serratus palsy is difficult to predict, especially if, in initial electromyographic examination, long thoracic nerve function is totally absent. How initial electromyography correlates with long-term outcome of isolated serratus palsy is unknown. We evaluated initial electromyographic examinations of isolated serratus palsy patients and compared these to their long-term outcome. We hypothesized that long-term outcome after electromyographic examination–verified partial nerve injuries is better than that seen in cases of total nerve injuries. Patients and Methods: We retrospectively reviewed 90 patients with isolated serratus palsy and with initial electromyographic examination treated by brace or observation only, by determining pain, range of motion, and degree of scapular winging after a mean follow-up of 17.8 years. Results: Initial electromyographic examination showed total denervation in 21 cases (22%), partial severe denervation in 30 (33%), and partial moderate or slight denervation in 39 (44%). Recovery of serratus muscle function occurred in 17/21 cases (81%) of total denervation and in 47/69 cases (68%) of partial denervation, p = 0.247. Mean flexion in total denervation recovered to 152° and in partial to 157°, p = 0.301, and abduction to 173° and 174°, p = 0.970. In total denervation, 60% of patients were pain-free, in partial, 48%, p = 0.338. The duration of scapular winging among those 42 who subjectively recovered averaged 15.1 months, in 13 patients with total denervation 15.9 months, and in 29 patients with partial denervation 14.7 months (p = 0.599). Conclusion: Initial electromyographic examination does not predict clinical outcomes: ROM, pain, scapular winging and strength, but partial denervation may negatively predict subjective outcome.

scholarly journals Sonoanatomy revisited: the long thoracic nerve

2019 ◽  
Vol 21 (3) ◽  
pp. 349 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Kamal Mezian ◽  
Ondřej Naňka ◽  
Levent Özçakar
Keyword(s):  
Distal Segment ◽  
Serratus Anterior Muscle ◽  
Accidental Injury ◽  
Serratus Anterior ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Long Thoracic Nerve ◽  
Scanning Method ◽  
Thoracic Nerve ◽  
Scapular Winging

The long thoracic nerve (LTN) arises from the C5, C6 and C7 roots and innervates the serratus anterior muscle. Scapular winging is the landmark manifestation of LTN neuropathy and may develop after an accidental injury during selective cervical nerve root or inter-scalene brachial plexus blocks. Although its sonoanatomy has been described in the previous literature, how to gradually identify the entire nerve course has rarely been discussed. In this regard, the present paper aims to elaborate the scanning method of the LTN from its origin to its distal segment.

scholarly journals Scapular Winging following Sports-Related Injury in a Rugby Player

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Shinya Ishizuka ◽  
Akinori Kobayakawa ◽  
Hideki Hiraiwa ◽  
Hiroki Oba ◽  
Takefumi Sakaguchi ◽  
...  
Keyword(s):  
Physical Examination ◽  
Muscle Weakness ◽  
Sports Injury ◽  
High Viscosity ◽  
Rugby Player ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Scapular Winging ◽  
Male High School ◽  
The Right

The most common cause of medial scapular winging is long thoracic nerve palsy (LTN) and subsequent serratus anterior muscle dysfunction. A 16-year-old right-handed male high-school rugby player developed severe right-sided neck and shoulder pain after tackling an opponent while playing rugby. Six weeks after initial injury, the patient observed shoulder muscle weakness when performing his daily activities. On physical examination, limited active elevation of the right shoulder in the scapular plane and scapular winging was observed. Magnetic resonance imaging revealed atrophy of both the SA and subclavius muscles on the right side, and we initially suspected an LTN injury sustained. However, while detailing his history, the patient explained that he also had noted difficulty sucking high viscosity drinks such as shakes and smoothies since childhood. In addition, physical examination showed weakness of the orbicularis oculi muscle. Considering the facial muscle weakness, facioscapulohumeral dystrophy (FSHD) was also suspected, and genetic testing showed chromosome 4q35 deletion with restriction fragments 17 kb and 3 tandem repeated DNA confirming the diagnosis of FSHD. Clinicians should be aware that FSHD could be one of the differential diagnoses of scapular winging after sports injury, and surgeons should rule out the diagnosis of FSHD before performing any surgical treatment for SA palsy.

Axillary Artery Pseudoaneurysm After Revision Plate Osteosynthesis of a Midshaft Clavicle Fracture Nonunion

2020 ◽  
Vol 10 (3) ◽  
pp. e19.00591-e19.00591
Author(s):  
Reza Firoozabadi ◽  
Jacob Wilkerson ◽  
Jake Hemingway ◽  
Nam Tran
Keyword(s):  
Axillary Artery ◽  
Plate Osteosynthesis ◽  
Clavicle Fracture ◽  
Artery Pseudoaneurysm ◽  
Fracture Nonunion

Acromioclavicular Joint Separation

2010 ◽  
pp. 121
Author(s):  
Joel A. Vilensky ◽  
Edward C. Weber ◽  
Thomas E. Sarosi ◽  
Stephen W. Carmichael
Keyword(s):  
Acromioclavicular Joint ◽  
Joint Separation ◽  
Acromioclavicular Joint Separation
Sign in / Sign up

Export Citation Format

Share Document