Postoperative isolated dysfunction of the long thoracic nerve: a rare entity of uncertain etiology.
A "winged" scapula is a rare, poorly understood, and potentially disabling curiosity following anesthesia and surgery. It is produced by dysfunction of the long thoracic nerve and consequent paralysis of the serratus anterior muscle. A survey of senior anesthesiologists indicated a consistent lack of familiarity with the entity. This article presents six cases of postoperative long thoracic nerve palsy. In a literature review of 111 instances of long thoracic nerve palsy, 51 were trauma-related, 47 were either idiopathic or of debatable origin, and 13 appeared following a surgical or obstetrical procedure. Unprovable etiologic contentions were frequent. Considerations of the etiologies of postoperative long thoracic nerve palsies must include a coincidental infectious neuropathy ("neuralgic amyotrophy") as a valid alternative to the assertion that a preventable injury occurred during anesthesia.
Martin
J T
JT
Department of Anesthesiology, Medical College of Ohio, Toledo 43699.
D005260:Female; D008297:Male; D009135:Muscular Diseases / Q000209:etiology*; D010243:Paralysis / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D011183:Postoperative Complications; D012540:Scapula; D013900:Thoracic Nerves