Martin J T
Department of Anesthesiology, Medical College of Ohio, Toledo 43699.
Anesth Analg. 1989 Nov;69(5):614-9.
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.
“翼状”肩胛是麻醉和手术后一种罕见、了解甚少且可能致残的异常情况。它是由胸长神经功能障碍以及随之而来的前锯肌麻痹所致。一项对资深麻醉医生的调查表明，他们对这种情况普遍缺乏了解。本文介绍了6例术后胸长神经麻痹的病例。在对111例胸长神经麻痹病例的文献综述中，51例与创伤相关，47例病因不明或来源有争议，13例出现在外科手术或产科手术后。无法证实的病因争议很常见。对于术后胸长神经麻痹病因的考量必须包括一种巧合的感染性神经病变（“神经性肌萎缩”），作为麻醉期间发生可预防损伤这一说法的有效替代解释。
