Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury

J. D. Salazar, J. R. Doty, E. E. Tseng, P. C. Marin, J. A. Girotto, G. S. Roseborough, S. C. Yang, R. F. Heitmiller

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The objective was to determine the course of the long thoracic nerve relative to the scapula as an aid to the prevention of proximal long thoracic nerve injuries. Methods: Eighteen fresh cadavers (7 male, 11 female) were studied. Each was sequentially placed in the transaxillary and posterolateral thoracotomy positions, and the distance of the long thoracic nerve from the scapular tip and anterior scapular border was measured. The measurements were made bilaterally; the mean, standard deviation, and 99% confidence interval were calculated for each position by gender. Results: Distances from the scapular tip to the long thoracic nerve are listed as mean/outer range: transaxillary thoracotomy, male 4.9/7.0 cm left, 5.2/7.5 cm right; female 4.3/5.0 cm left, 4.7/6.0 cm right; posterolateral thoracotomy, male 3.1/6.0 cm left, 4.5/5.1 cm right; female 3.2/4.5 cm left, 3.8/5.5 cm right. In all instances, the long thoracic nerve was furthest from the scapula at its tip. Conclusion: For patients positioned for a transaxillary thoracotomy, incision sites should be at least 7.5 and 6.0 cm anterior to the scapular tip for male and female patients, respectively. For patients in posterolateral thoracotomy positioning, incisions should be 6.0 and 5.5 cm anterior to the scapular tip for male and female patients, respectively. By using these anatomic guidelines, we believe that the incidence of iatrogenic proximal long thoracic nerve injury can be minimized.

Original languageEnglish (US)
Pages (from-to)960-964
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume116
Issue number6
DOIs
StatePublished - 1998

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Relationship of the long thoracic nerve to the scapular tip: An aid to prevention of proximal nerve injury'. Together they form a unique fingerprint.

Cite this