Polyester tape scapulopexy for chronic upper extremity brachial plexus injury

Area of Science:

• Orthopedic surgery
• Neurosurgery
• Reconstructive surgery

Background:

• Chronic upper brachial plexus injuries can lead to persistent scapular winging.
• Restoration of shoulder function via nerve transfer is a prerequisite for addressing residual scapular instability.
• Scapular winging negatively impacts upper extremity function and aesthetics.

Purpose of the Study:

• To evaluate the efficacy of scapular stabilization using polyester tape in patients with winged scapula secondary to chronic upper brachial plexus injury.
• To assess functional outcomes, pain reduction, and patient satisfaction following the procedure.

Main Methods:

• Eight patients with winged scapula post-nerve transfer underwent scapular stabilization with polyester tape.
• Follow-up ranged from 24 to 40 months (mean 38 months).
• Outcome measures included radiographic analysis, range of motion, University of California Los Angeles (UCLA) shoulder score, and visual analog scale (VAS) pain score.

Main Results:

• All patients experienced clinical improvement, with 5 showing complete resolution of scapular winging and 3 with mild residual winging.
• Mean active forward flexion improved from 101° to 127°, and abduction from 91° to 121°.
• Mean UCLA score increased from 17 to 27, and mean VAS pain score decreased from 6.1 to 0.7. Patient satisfaction with appearance was high.

Conclusions:

• Polyester tape scapulopexy offers favorable short-to-intermediate term outcomes for winged scapula in this patient population.
• The procedure effectively improves appearance, upper extremity function, and reduces pain.
• Scapular stabilization is a valuable adjunct following successful nerve transfers for brachial plexus injuries.