Surgical release of the long thoracic nerve may improve isolated paralysis of the serratus anterior

Scapular winging may result from a compression syndrome of the long thoracic nerve (LTN). We observed that anatomical structures may constitute mechanical constraints to the thoracic portion of the LTN. The present study includes 13 consecutive patients (10 men and 3 women) who underwent neurolysis of the LTN during a 4-years period. The average age was 30 years (from 18 to 49). The cause of the paralysis was a single trauma in 5 cases and a sports or professional overuse in 8 cases. At the longest follow-up all the patients presented a complete or near complete muscular recovery and were very satisfied with the result. In the absence of spontaneous recovery, surgical release of the thoracic portion of the LTN is a safe and efficient procedure.