Management of Long Thoracic Nerve Palsy includes which of the following?

Management of Long Thoracic Nerve Palsy includes which of the following?

• A. Physical therapy, occupational therapy, scapulothoracic fusion.
• B. Intravenous antibiotics only.
• C. Steroid injections.
• D. Chemotherapy.

Answer: (A)

Management focuses on restoring scapular stability through targeted rehabilitation, with surgery reserved for cases that don’t improve. Long thoracic nerve palsy weakens serratus anterior, causing the scapula to wobble and wing during pushing and overhead movements. The best approach is conservative care: physical therapy and occupational therapy to strengthen the periscapular muscles, improve scapulothoracic mechanics, and correct posture, plus activity modification and pain control as needed. If these nonoperative measures fail to restore function and significant winging persists, scapulothoracic fusion can be considered as a salvage option to stabilize the scapula and improve function. Intravenous antibiotics, steroid injections, and chemotherapy don’t address the underlying nerve weakness or the mechanics of the scapulothoracic joint, so they aren’t appropriate primary treatments for this condition.

Management focuses on restoring scapular stability through targeted rehabilitation, with surgery reserved for cases that don’t improve. Long thoracic nerve palsy weakens serratus anterior, causing the scapula to wobble and wing during pushing and overhead movements. The best approach is conservative care: physical therapy and occupational therapy to strengthen the periscapular muscles, improve scapulothoracic mechanics, and correct posture, plus activity modification and pain control as needed. If these nonoperative measures fail to restore function and significant winging persists, scapulothoracic fusion can be considered as a salvage option to stabilize the scapula and improve function.

Intravenous antibiotics, steroid injections, and chemotherapy don’t address the underlying nerve weakness or the mechanics of the scapulothoracic joint, so they aren’t appropriate primary treatments for this condition.