The Long Thoracic Nerve is vulnerable to damage, probably because its anatomical course is long and exposed.
Disruption results only in winging of the scapula, that is, the shoulder-blade protrudes, no longer lies flat against the chest wall. Some sufferers report a preliminary and transient dull aching, but the nerve only contains motor (movement) fibres, so pain is not a feature.
The cause of a Long Thoracic Nerve Palsy may be trauma or surgery, but is frequently unknown
As with other nerves, direct traumatic, ,  or surgical injury accounts for some cases, but spontaneous failure is characteristic of the Long Thoracic Nerve, and various mechanisms have been proposed. Many occurrences are unexplained, and some follow general anesthesia without recognised departure from standard nursing and anesthetic practice.
Post-anesthesia cases for remote surgery are generally not caused by recognised substandard technique
The paralysis is generally permanent, and may disable activities dependent on the stability of the shoulder girdle. Some sufferers are able to compensate by using other muscles.
Therapy is generally ineffective, at least partial permanent disability usual
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