JTCS Tips for Better Browsing
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Jorge D. Salazar
John R. Doty
Elaine E. Tseng
Stephen C. Yang
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Salazar, J. D.
Right arrow Articles by Heitmiller, R. F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Salazar, J. D.
Right arrow Articles by Heitmiller, R. F.

J Thorac Cardiovasc Surg 1998;116:960-964
© 1998 Mosby, Inc.

GENERAL THORACIC SURGERY

RELATIONSHIP OF THE LONG THORACIC NERVE TO THE SCAPULAR TIP: AN AID TO PREVENTION OF PROXIMAL NERVE INJURY

Jorge D. Salazar, MD, John R. Doty, MD, Elaine E. Tseng, MD, Philip C. Marin, MD, John A. Girotto, MD, Glen S. Roseborough, MD, Stephen C. Yang, MD, Richard F. Heitmiller, MD

This work was supported by the Evelyn Glick Fund for Thoracic Surgery.

Received for publication March 19, 1998. Revisions requested May 13, 1998; revisions Received Aug 25, 1998. Accepted for publication Aug 28, 1998. Address for reprints: Richard F. Heitmiller, MD, Osler 624, Johns Hopkins Hospital, Baltimore, MD 21287-5674.

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.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1998 by The American Association for Thoracic Surgery.