Serratus anterior palsy secondary to long thoracic nerve dysfunction

LTN dysfunction leading to SA palsy can be typically diagnosed with certain physical examination findings and confirmed using electromyogram with nerve conduction studies. Although spontaneous recovery can occur, patients with persistent serratus weakness may be considered for neurolysis, nerve transfer, or tendon transfer. Currently, direct transfer of the sternal head of the pectoralis major to the inferior pole of the scapula is our management of choice for patients with disabling symptoms and no improvement despite a good program of physical therapy.