Chiropractors/Pectoralis major transfer

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Expert: Dr. J. Shawn Leatherman - 9/23/2007


Question
I had shoulder surgery in Feb. 2007. A simple bone spur removal and minor rotator cuff stitch. I also had this same shoulder repaired in 1996, rotator cuff repair, AC joint removed and part of the clavical removed. I had a shoulder block for this most recent surgery. A few days after surgery we noticed what looked like a seperated deltoid, then a winging scapular. Therapy was tried for three months. However the pain was too much so therapy was discontinued.

I have had several EMG's. The findings were chronic denervation in muscles supplied by the right thoracic nerve and right axillary nerve consistent with meuralgic amyatrophy. No evidence of upper brachial plexopathy or ongoing acute denervation. There is mild chronic bilateral primarily c5-c6 radiculopathy.

I have seen many doctors, the latest saying to observe for 6 more months. If not improved at that time, then we will discuss a pectoralis major transfer using Achilles tendon allograft. I have also been advised not to work on active elevation due to the extra forceit requires. This same doctor has advised me that the deltoid did not seperate but has fallen off the clavical.

My question is this, how safe is a pectoralis major transfer, could I be worse afterwards? do you know of any other options? I have been told the deltoid cannot be put back on the clavical, is this so? Could the LTN injury be from the block or was it something that was occuring from my prior surgery? I was fine from 1996 - 2006. The pain I am in now is far grater then what I was experiencing prior to surgery. do you have any words of hope for me.

Thank you.  

Answer
Dear Virginia,

Unfortunately, the long thoracic nerve is often cut in surgeries like you have experienced, while the axillary nerve can be as well.  The resolution of this problem is unlikely though as your initial rehab program did not give you appreciable results.

Concerning further surgical applications, this question is really out of my area of expertise, and I don't think my opinion would be of benefit to you.  I would suggest that you utilize another section of all experts for a surgeons opinion on this, (preferably an orthopedic surgeon) as they have been better trained in this area.

Good luck Virginia, I wish you all the best.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net

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Dr. J. Shawn Leatherman

Expertise

I can answer questions on general chiropractic care, sports injury, whiplash and auto crash, mild traumatic brain injury, structural and functional rehabilitation of the spine, nutrition for inflammation and repair, fitness training, nutrition for sports performance and other general health and nutrition related inquiries. I currently lecture on automobile trauma, occupant kinematics, and forensic risk analysis to local EMS, Fire and Police, as well as nutrition and sports injury to community groups. Rest assured all answers are generated from my clinical experience, and scientific research.

Experience

I have accumulated over 1100 hours of post-doctoral training to include; Certifications in Spinal Trauma and Mild Traumatic Brain Injury from the Spine Research Institute of San Diego, Certification in Chiropractic Spinal Trauma from the International Chiropractic Association, Certification in Low Speed Auto Crash Reconstruction and Certification in Forensic Risk Analysis from The Center for Research Into Automotive Safety and Health, Certified Proficiency in spinal and extremity diagnostic procedures from The Motion Palpation Institute, Certified in Sports Injury and Rehabilitation from the National University of Health Sciences and The American Chiropractic Board of Sports Physicians, Nationally Certified Fellow of Structural Rehabilitation from The Chiropractic Biophysics Organization, and I have advanced training in manipulation under anesthesia and nutrition. Feel free to check out my website for course listings: www.suncoasthealthcare.net

Organizations
International Chiropractic Association, Florida Chiropractic Association, American Chiropractic Board of Sports Physicians, American Academy of Pain Management, Chiropractic Biophysics, Spine Research Institute of San Diego, Center for Research Into Automotive Safety and Health, Motion Palpation Organization, American Academy of Manual and Physical Medicine, Fort Walton Beach Chamber of Commerce

Education/Credentials
B.A. (Psychology)The University of Cincinnati B.S. (Human Biology)Cleveland Chiropractic College D.C. (Doctor of Chiropractic) Cleveland Chiropractic College C.C.S.T. (Certification in Chiropractic Spinal Trauma)The International Chiropractic Association C.C.S.P. (Certified Chiropractic Sports Physician)The American Chiropractic Board of Sports Physicians. *CCST and CCSP 120 hour certification courses are not recognized by the Florida Chiropractic Board due to the fact that they are not 300 hour diplomate level courses*

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