Ago Kentaro, Matsumura Noboru, Iwamoto Takuji, Sato Kazuki, Nakamura Masaya, Matsumoto Morio
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
JBJS Case Connect. 2017 Apr-Jun;7(2):e23. doi: 10.2106/JBJS.CC.16.00162.
A 37-year-old man with scapular winging, caused by combined palsy of the spinal accessory nerve and the long thoracic nerve, was successfully treated with a pectoralis major transfer to substitute for the serratus anterior muscle, and with levator scapulae and rhomboid muscle transfers to substitute for the trapezius muscle.
The serratus anterior paralysis was thought to have occurred secondary to traction of the long thoracic nerve by the unsupported scapula following the spinal accessory nerve palsy. Even with combined paralyses of the serratus anterior and trapezius muscles, combined muscle transfers that substitute for the paralyzed muscles can improve shoulder function.
一名37岁男性因副神经和胸长神经联合麻痹导致肩胛翼状畸形，通过胸大肌移位替代前锯肌、提肩胛肌和菱形肌移位替代斜方肌，治疗取得成功。
认为前锯肌麻痹是由于副神经麻痹后肩胛骨失去支撑，胸长神经受牵拉继发所致。即使前锯肌和斜方肌联合麻痹，通过联合肌肉移位替代麻痹肌肉也可改善肩部功能。
