Watson C J, Schenkman M
Department of Physical and Occupational Therapy, Duke University Medical Center, Durham, NC 27710.
Phys Ther. 1995 Mar;75(3):194-202. doi: 10.1093/ptj/75.3.194.
This case report presents a patient who developed right shoulder pain following strenuous upper-extremity exercise. Approximately 6 weeks later his pain resolved, he noticed persistent right upper-extremity weakness. He was referred to physical therapy for evaluation and treatment. Physical therapy evaluation revealed isolated serratus anterior muscle paralysis. A long thoracic neuropathy was subsequently confirmed by electromyographic testing. The etiology, pathophysiology, and pathokinesiology of serratus anterior muscle paralysis are reviewed. A case is presented, illustrating how the clinical decision making is based on the pathokinesiology and pathophysiology. The patient was followed over the course of 17 months and has recovered full right shoulder active range of motion. His serratus anterior muscle strength has increased to Good minus, and he reports significantly improved functional use of the upper extremity.
本病例报告介绍了一名患者，该患者在进行剧烈上肢运动后出现右肩疼痛。大约6周后疼痛缓解，他注意到右上肢持续无力。他被转介至物理治疗科进行评估和治疗。物理治疗评估显示孤立的前锯肌麻痹。随后通过肌电图测试确诊为长胸神经病变。本文回顾了前锯肌麻痹的病因、病理生理学和病理运动学。文中呈现了一个病例，说明临床决策是如何基于病理运动学和病理生理学做出的。该患者在17个月的病程中接受随访，右肩已恢复完全的主动活动范围。他的前锯肌力量已增强至良-，并且他报告上肢的功能使用有了显著改善。
