Keles Aslinur, Giray Esra, Nur Balatlioglu Melike, Unlu Ozkan Feyza, Aktas Ilknur
Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Türkiye.
Turk J Phys Med Rehabil. 2025 Feb 14;71(1):117-121. doi: 10.5606/tftrd.2025.15331. eCollection 2025 Mar.
The most common etiologic cause of winged scapula (WS) is paralysis of the serratus anterior muscle (SAM), typically due to an injury of the long thoracic nerve (LTN), often associated with overhead activities, including heavy weightlifting. Herein, we reported a 30-year-old male patient with WS secondary to an LTN lesion caused by carrying weight under the armpit, rather than overhead, which differs from previous reports regarding the anatomical site and cause of the LTN lesion. The ultrasonographic technique used to evaluate distal lesions of the LTN was described in detail, with the SAM thickness significantly reduced and the cross-sectional area of the LTN increased on the symptomatic side. Electroneuromyography revealed an acute/subacute, mild partial axonal lesion of the LTN, with ultrasonographic evaluation pinpointing the exact anatomical location of the lesion. Ultrasonography should be the first imaging modality used to support electrophysiological studies and evaluate the affected nerves and muscles to reveal precise anatomical localization.
翼状肩胛（WS）最常见的病因是前锯肌（SAM）麻痹，通常是由于胸长神经（LTN）损伤所致，常与包括重物举重在内的过头活动有关。在此，我们报告了一名30岁男性患者，其WS继发于因腋下负重而非过头负重导致的LTN损伤，这与先前关于LTN损伤的解剖部位和病因的报道不同。详细描述了用于评估LTN远端损伤的超声技术，患侧SAM厚度显著减小，LTN横截面积增大。神经电生理检查显示LTN存在急性/亚急性、轻度部分轴索性损伤，超声评估可精确确定损伤的解剖位置。超声检查应作为支持电生理研究和评估受累神经及肌肉以揭示精确解剖定位的首选影像学方法。
