Occupational shoulder disability: functional recovery after decompression and neurolysis of the upper brachial plexus and the long thoracic nerve

• Authors: Rahul K. Nath , Alyssa M. Leal , Chandra Somasundaram

Abstracts

EN

ObjectivesThis study aimed to assess the surgical outcomes of patients with work-related upper extremity musculoskeletal disorders (UE-MSDs) who failed conservative treatment.Material and MethodsThis was a retrospective study of 17 patients who had work-related UE-MSDs and underwent the following surgeries and follow-up evaluations: decompression, external and internal neurolysis of the upper trunk of the brachial plexus and the long thoracic nerve (LTN), and a partial resection of the anterior and middle scalene muscle. A detailed history of clinical presentation including pain, physical and clinical examinations of the extent of scapular winging (ESW), and upper extremity anatomical postures, such as active forward arm flexion and shoulder abduction, were recorded before and after 3 months of the surgery. Nerve conduction velocity and electromyography examination reports were obtained to assess the sensory or motor loss of the nerve injury before their operation.ResultsAll 17 patients included in this report showed some improvement anatomically in the scapula appearance and functionally in their shoulder movements. More specifically, 9 (53%) patients got a restored to near healthy appearance of the scapula, and 11 (65%) patients recovered a full range of motion, 180° post-surgically. Overall, the mean shoulder flexion and abduction improved to 157±37.5° and 155±40.2° after the surgery from 106±30.2° and 111±34.8°, respectively (p < 0.0001). The ESW score also significantly improved from a mean of 1.5±0.51 to 3.5±0.71 (p < 0.0001). The post-surgical improvements were statistically highly significant (p < 0.0001).ConclusionsDecompression and neurolysis of the upper brachial plexus and the LTN, and the partial release of the scalene muscle contracture procedures have fostered improvements in the shoulder anatomical appearance and movements in all 17 patients.

Keywords

EN

shoulder injury; winging scapula; musculoskeletal disorders; occupational injury; anatomical postures; shoulder movements

• Publisher: Instytut Medycyny Pracy im. prof. dra Jerzego Nofera w Łodzi
• Journal: International Journal of Occupational Medicine and Environmental Health
• Year: 2021
• Volume: 34
• Issue: 3
• Pages: 427-435

Dates

published

2021

Contributors

author

Rahul K. Nath

• Texas Nerve and Paralysis Institute, Houston, USA (Research Division)

author

Alyssa M. Leal

• Texas Nerve and Paralysis Institute, Houston, USA (Research Division)

author

Chandra Somasundaram

• Texas Nerve and Paralysis Institute, Houston, USA (Research Division)

Identifiers

DOI

10.13075/ijomeh.1896.01634

Biblioteka Nauki

2085778