Scapular Winging Secondary to Apparent Long Thoracic Nerve Palsy in a Young Female Swimmer.

IF 1.1 Q4 CLINICAL NEUROLOGY Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2015-11-06 eCollection Date: 2015-12-01 DOI:10.1055/s-0035-1567806
Shiro Nawa
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引用次数: 9

Abstract

Background:  In neurological diseases, winging of the scapula occurs because of serratus anterior muscle dysfunction due to long thoracic nerve palsy, or trapezius muscle dysfunction due to accessory nerve palsy. Several sports can cause long thoracic nerve palsy, including archery and tennis. To our knowledge, this is the first report of long thoracic nerve palsy in an aquatic sport.

Objective:  The present study is a rare case of winging of the scapula that occurred during synchronized swimming practice.

Methods:  The patient's history with the present illness, examination findings, rehabilitation progress, and related medical literature are presented.

Results:  A 14-year-old female synchronized swimmer had chief complaints of muscle weakness, pain, and paresthesia in the right scapula. Upon examination, marked winging of the scapula appeared during anterior arm elevation, as did floating of the superior angle. After 1 year of therapy, right shoulder girdle pain and paresthesia had disappeared; however, winging of the scapula remained.

Conclusions:  Based on this observation and the severe pain in the vicinity of the second dorsal rib, we believe the cause was damage to the nerve proximal to the branch arising from the upper nerve trunk that innervates the serratus anterior.

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年轻女游泳运动员继发于明显胸长神经麻痹的肩胛骨翅。
背景:在神经系统疾病中,由于胸长神经麻痹引起的前锯肌功能障碍或副神经麻痹引起的斜方肌功能障碍而发生肩胛骨翅。一些运动可以引起长胸神经麻痹,包括射箭和网球。据我们所知,这是水上运动中首次报道胸长神经麻痹。目的:研究一例在花样游泳练习中发生的肩胛骨翅动。方法:对患者的病史、检查结果、康复进展及相关医学文献进行回顾性分析。结果:一名14岁女子花样游泳运动员的主诉是右肩胛骨肌肉无力、疼痛和感觉异常。检查发现,在上臂前抬时,肩胛骨有明显的翅状,上角也有浮动。治疗1年后,右肩带疼痛和感觉异常消失;然而,肩胛骨的翅膀保留了下来。结论:根据这一观察和第二背肋附近的剧烈疼痛,我们认为原因是神经近端损伤,神经近端来自支配前锯肌的上神经干。
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来源期刊
CiteScore
1.70
自引率
14.30%
发文量
6
审稿时长
12 weeks
期刊介绍: JBPPNI is an open access, peer-reviewed online journal that will encompass all aspects of basic and clinical research findings, in the area of brachial plexus and peripheral nerve injury. Injury in this context refers to congenital, inflammatory, traumatic, degenerative and neoplastic processes, including neurofibromatosis. Papers on diagnostic and imaging aspects of the peripheral nervous system are welcomed as well. The peripheral nervous system is unique in its complexity and scope of influence. There are areas of interest in the anatomy, physiology, metabolism, phylogeny, and limb growth tropism of peripheral nerves.
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