II. Anatomy
- Long Thoracic Nerve forms from C5-7 nerve roots at the middle scalene Muscle
III. Causes
- Direct blow to Shoulder
- Direct blow to pectoralis Muscle at rib 4-5 at nerve exit site
- Chronic repetitive overhead Shoulder traction (e.g. tennis, volleyball, swimming, baseball)
- Traction injury at the middle scalene Muscle
- Radical Mastectomy
V. Signs
- Forward flexion weakness at Shoulder
- Scapular Winging
VI. Diagnostics
- Nerve Conduction Studies and EMG
-
Shoulder MRI
- Not typically indicated but may show supraspinatus and infraspinatus denervation changes
VII. Management
-
Shoulder Range of Motion Exercises
- Prevents Frozen Shoulder and contractures
- Strengthen remaining Shoulder stabilizing Muscles
- Surgery is rarely indicated
- Consider surgery for Penetrating Trauma with nerve transection
- Consider surgery for lack of improvement at 18 to 24 months
VIII. Course
- Therapy leads to recovery times typically of 9-12 months (may require up to 2 years)
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Related Studies
Concepts | Injury or Poisoning (T037) |
SnomedCT | 212291002 |
English | Long thoracic nerve injury, Long thoracic nerve injury (disorder) |
Spanish | lesión traumática del nervio torácico largo (trastorno), lesión traumática del nervio torácico largo |
Ontology: Long thoracic nerve lesion (C0574905)
Concepts | Disease or Syndrome (T047) |
SnomedCT | 298119007 |
English | Long thoracic nerve lesion, Long thoracic nerve lesion (disorder) |
Spanish | lesión del nervio torácico largo (trastorno), lesión del nervio torácico largo |
Ontology: Long thoracic nerve palsy (C2062708)
Concepts | Disease or Syndrome (T047) |
English | nerve palsy long thoracic, long thoracic nerve palsy (diagnosis), long thoracic nerve palsy, Long thoracic nerve palsy |
Spanish | Parálisis del nervio torácico largo |
Dutch | nervus thoracicus longus verlamming |
German | Laehmung des Nervus thoracicus longus |
Japanese | チョウキョウシンケイマヒ, 長胸神経麻痺 |
Czech | Obrna dlouhého torakálního nervu |
Portuguese | Paralisia do nervo torácico longo |
Italian | Paralisi del nervo toracico lungo |
French | Paralysie du nerf thoracique long |
Hungarian | Hosszú mellkasi ideg bénulása |