長胸神経麻痺による翼状肩甲骨に対し大胸筋移行術を施行した 1 例

概要

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Serratus anterior paralysis results in winging scapula and weakness of the arm elevation. The etiology of the paralysis is thought to be injury of the long thoracic nerve. Although most of the patients recover nerve function with conservative treatment, surgical treatment using pectoralis major transfer would be necessary for patients who have no change with conservative treatment. We presented that 34-year-old man who noticed nuchal pain and scapular region pain with right arm elevation. His right arm gradually could not actively elevate and winging scapula deteriorated with no history of trauma. EMG showed the denervation patterns in long thoracic nerve. Because there was no effect with conservative treatment, we performed pectoralis major muscle transfer augumented with autogenous hamstring graft. His winging scapula recovered and shoulder function was restored 1 year after the operation. Pectoralis major muscle transfer augumented with autogenous hamstring graft would be an effective treatment for recalcitrant scapular winging resulting from long thoracic nerve palsy.
日本肩関節学会の論文