The authors report a case of long thoracic nerve (LTN) palsy treated with two-level motor nerve transfers of a pectoral fascicle of the middle trunk, and a branch of the thoracodorsal nerve. This procedure resulted in near-total improvement of the winged scapula deformity, and a return of excellent shoulder function. A detailed account of the postoperative physical therapy regimen is included, as this critical component of the favorable result cannot be overlooked. This case establishes the two-level motor nerve transfer as a new option for treating LTN palsy, and demonstrates that nerve transfers should be considered in the therapeutic algorithm of an idiopathic mononeuritis.

Original languageEnglish
Pages (from-to)858-864
Number of pages7
JournalJournal of neurosurgery
Issue number4
StatePublished - Oct 1 2011


  • Brachial neuritis
  • Long thoracic nerve
  • Nerve transfer
  • Peripheral nerve


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