Scratch Collapse Test Is a Useful Clinical Sign in Assessing Long Thoracic Nerve Entrapment

Abstract

The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. Initially described for carpal and cubital tunnel syndromes, subsequent authors have found it useful for the assessment of median, ulna, radial, axillary, and common peroneal nerves. We report a case illustrating the value of the SCT in the clinical assessment of thoracic nerve entrapment.

Keywords

long thoracic nerve - long thoracic nerve palsy - nerve entrapment - scapula winging - scratch collapse test

Informed Consent

Informed consent was obtained from the individual participant included in the study. Additional informed consent was obtained from the participant for whom identifying information is included in this article.

• References

• 1 Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. J Hand Surg Am 2008; 33 (9) 1518-1524
• 2 Gillenwater J, Cheng J, Mackinnon SE. Evaluation of the scratch collapse test in peroneal nerve compression. Plast Reconstr Surg 2011; 128 (4) 933-939
• 3 Hagert E, Hagert C-G. Upper extremity nerve entrapments: the axillary and radial nerves—clinical diagnosis and surgical treatment. Plast Reconstr Surg 2014; 134 (1) 71-80
• 4 Blok RD, Becker SJE, Ring DC. Diagnosis of carpal tunnel syndrome: interobserver reliability of the blinded scratch-collapse test. J Hand Microsurg 2014; 6 (1) 5-7
• 5 Makanji HS, Becker SJE, Mudgal CS, Jupiter JB, Ring D. Evaluation of the scratch collapse test for the diagnosis of carpal tunnel syndrome. J Hand Surg Eur Vol 2014; 39 (2) 181-186
• 6 Witt JC, Hentz JG, Stevens JC. Carpal tunnel syndrome with normal nerve conduction studies. Muscle Nerve 2004; 29 (4) 515-522
• 7 Brown JM, Mokhtee D, Evangelista MS, Mackinnon SE. Scratch collapse test localizes Osborne's band as the point of maximal nerve compression in cubital tunnel syndrome. Hand (NY) 2010; 5 (2) 141-147
• 8 Bertelli JA, Ghizoni MF. Long thoracic nerve: anatomy and functional assessment. J Bone Joint Surg Am 2005; 87 (5) 993-998
• 9 Horwitz MT. Isolated paralysis of the serratus anterior (magnus) muscle. J Bone Joint Surg Am 1938; 20 (3) 720-725
• 10 Hester P, Caborn DNM, Nyland J. Cause of long thoracic nerve palsy: a possible dynamic fascial sling cause. J Shoulder Elbow Surg 2000; 9 (1) 31-35
• 11 Maire N, Abane L, Kempf JF, Clavert P ; French Society for Shoulder and Elbow SOFEC. Long thoracic nerve release for scapular winging: clinical study of a continuous series of eight patients. Orthop Traumatol Surg Res 2013; 99 (6, Suppl): S329-S335
• 12 Nath RK, Lyons AB, Bietz G. Microneurolysis and decompression of long thoracic nerve injury are effective in reversing scapular winging: long-term results in 50 cases. BMC Musculoskelet Disord 2007; 8: 25
• 13 Le Nail LR, Bacle G, Marteau E, Corcia P, Favard L, Laulan J. Isolated paralysis of the serratus anterior muscle: surgical release of the distal segment of the long thoracic nerve in 52 patients. Orthop Traumatol Surg Res 2014; 100 (4, Suppl): S243-S248
• 14 Novak CB, Mackinnon SE. Surgical treatment of a long thoracic nerve palsy. Ann Thorac Surg 2002; 73 (5) 1643-1645