Klebe Thomas M, Døssing Kaj V, Blenstrup Torben, Nielsen-Ferreira June, Rejsenhus Lisbeth, Aalkjaer Grethe, Breddam Marianne
Viborg Sygehus, Ortopaedkirurgisk Afdeling.
Ugeskr Laeger. 2003 Apr 21;165(17):1779-82.
Scapula winging is characterized by a paresis/paralysis of either m. serratus anterior innervated by n. thoracis longus or m. trapezius innervated by n. accesorius. This investigation reveals the results after bracing and muscle training in patients suffering from scapula winging.
A prospective, consecutive series consisting of 64 patients, 43 males and 21 females with a mean age of 37.8 years (15-75 years), were treated with bracing and muscle training in 1998-2001. Prior to the treatment of bracing all patients suffered from shoulder pain, shoulder fatigue and limited range of motion as well as cosmetic complaints, 28 patients had shoulder pain.
At the time of the investigation all 64 patients had stopped using the brace after an average of 11 months (3-29 months). A total of 61 patients had returned to their previous work and sports activities. By the time of the one year follow-up control 18 (50%) patients had gained normal shoulder functions and had no complaints and no visible scapula winging. Ten (32%) had minor disability and two (6%) had major disability. Two patients had relapse of their scapula winging. (Both patients had formerly had normal ENG/EMG).
We find that the combination of bracing and muscle training is successful in treating scapula winging. Electroneurography (ENG)/electromyography (EMG) was routinely performed but did not show any prognostic value for the treatment in our investigation.
肩胛翼状畸形的特征是由胸长神经支配的前锯肌或由副神经支配的斜方肌出现轻瘫/瘫痪。本研究揭示了肩胛翼状畸形患者在使用支具和进行肌肉训练后的结果。
1998年至2001年,对64例患者(43例男性和21例女性,平均年龄37.8岁,年龄范围15 - 75岁)进行了前瞻性连续研究,采用支具和肌肉训练进行治疗。在使用支具治疗前,所有患者均有肩部疼痛、肩部疲劳、活动范围受限以及外观方面的问题,其中28例患者有肩部疼痛。
在调查时,所有64例患者在平均使用支具11个月(3 - 29个月)后停止使用。共有61例患者恢复了之前的工作和体育活动。到一年随访时,18例(50%)患者肩部功能恢复正常,无不适症状,肩胛无明显翼状畸形。10例(32%)有轻度残疾,2例(6%)有重度残疾。2例患者肩胛翼状畸形复发。(这2例患者之前ENG/EMG检查结果正常)。
我们发现支具和肌肉训练相结合在治疗肩胛翼状畸形方面是成功的。在我们的研究中,常规进行了神经电图(ENG)/肌电图(EMG)检查,但未显示出对治疗有任何预后价值。