title: Pectoralis major to scapula transfer for patients with serratus anterior palsy.
abstract: Serratus anterior palsy can be a very disabling condition. However, not much has been written about many other upper limb palsies and the surgical approaches for them. In contrast, not much has been published about this particular muscle palsy. Most investigators engaged in the treatment of peripheral nerve palsies are focused on the restoration of elbow flexion/extension and shoulder abduction/external rotation. Nevertheless, scapulothoracic stability is of utmost importance for shoulder function inasmuch as it offers a stable base for arm motion--mostly forward flexion. As a result, serratus anterior palsy leads to loss of strength, range of motion, and pain due to fatigue of synergistic muscles--an issue disabling enough to warrant surgical intervention. Many investigators have suggested a variety of techniques including muscle transfers, fascial slings, or scapulothoracic fusion. The last option leads to obvious limitations in the final range of motion and should be avoided in young high-demand patients. Fascial slings have a tendency to attenuate over time.
authors.affiliation: Complexo Hospitalar Santa Casa, Porto Alegre, Rio Grande do Sul, Brazil. cristian.ort@terra.com.br
authors.forename: Cristian Stein
authors.initials: CS
authors.lastname: Borges
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Ruschel
authors.forename: Marco Tonding
authors.initials: MT
authors.lastname: Ferreira
mesh_terms: D005206:Fascia Lata / Q000637:transplantation*; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D018482:Muscle, Skeletal / Q000294:innervation*; D010243:Paralysis / Q000601:surgery*; D010369:Pectoralis Muscles / Q000601:surgery; D011182:Postoperative Care; D016059:Range of Motion, Articular; D012540:Scapula / Q000601:surgery*; D012785:Shoulder Joint / Q000294:innervation; D013709:Tendon Transfer / Q000379:methods*