Microneurolysis and decompression of long XXXX are effective in reversing scapular winging: long-term results in 50 cases.

@entity1 @entity64 @entity11438 @entity1514 @entity2982 @entity764 @entity158 @entity717 @entity130
BACKGROUND: Long @entity764 leading to scapular winging is common, often caused by closed @entity130 through compression, stretching, traction, direct extrinsic force, @entity2982 , or neuritides such as @entity11438 . We undertook the largest series of long thoracic nerve decompression and neurolysis yet reported to demonstrate the @entity1514 . METHODS: Winging was bilateral in 3 of the 47 @entity1 (26 male, 21 female), yielding a total of 50 procedures. The mean age of the @entity1 was 33.4 years, ranging from 24-57. Causation included heavy weight-lifting (31 @entity1 ), repetitive throwing (5 @entity1 ), deep massage (2 @entity1 ), repetitive @entity717 (1 @entity1 ), direct @entity130 (1 @entity1 ), @entity64 (1 @entity1 ), and idiopathic causes (9 @entity1 ). Decompression and microneurolysis of the long thoracic nerve were performed in the supraclavicular space. Follow-up (average of 25.7 months) consisted of physical examination and phone conversations. The degree of winging was measured by the operating surgeon (RKN). @entity1 also answered questions covering 11 quality-of-life facets spanning four domains of the World Health Organization Quality of Life questionnaire. RESULTS: @entity1514 and neurolysis improved scapular winging in 49 (98%) of the 50 cases, producing "good" or "excellent" results in 46 cases (92%). At least some improvement occurred in 98% of cases that were less than 10 years old. @entity158 reduction through surgery was good or excellent in 43 (86%) cases. Shoulder instability affected 21 @entity1 preoperatively and persisted in 5 of these @entity1 after surgery, even in the 5 @entity1 with persistent instability who experienced some relief from the winging itself. CONCLUSION: Surgical decompression and neurolysis of the long thoracic nerve significantly improve scapular winging in appropriate @entity1 , for whom these techniques should be considered a primary modality of functional restoration.
