Entire pectoralis major tendon transfer with the hamstring tendon autograft for the treatment of scapular winging due to long thoracic nerve injury

Aim
The aim of this study was to evaluate the results of treatment of patients with scapular winging due to long thoracic nerve (LTN) injury through the indirect transfer of the entire pectoralis major tendon (PMT) using the hamstring autograft.
Patients and methods
Between November 2011 and October 2012, six patients with painful scapular winging due to LTN injury underwent PMT transfer at Mansoura University Hospital and a private hospital. All patients were male with a mean age of 35.2 years at the time of surgery. All patients underwent clinical examination. All patients underwent plain radiography of the shoulder and electromyography and nerve conduction for the LTN. All patients were treated with the indirect transfer of the entire PMT to the inferior angle of the scapula using the hamstring autograft.
Results
The mean preoperative to postoperative results included increases in active forward flexion from 142.5° to 167.5° and active external rotation from 50° to 65°, and improvement in the American Shoulder and Elbow Surgeons score from 30 to 71.6 and Visual Analog Scale pain score from 6.3 to 1.8.
Conclusion
Entire PMT transfer with the hamstring tendon autograft is effective for restoring shoulder function, relieving shoulder pain, and treating scapular winging caused by serratus anterior paralysis due to electromyography-confirmed LTN injury.