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Modified Eden-Lange Procedure for Trapezius Paralysis with Ipsilateral Rotator Cuff-Tear ArthropathyA Case Report
John G. Skedros, MD; Casey J. Kiser, BS
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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5323 South Woodrow Street, Suite 202, Salt Lake City, UT 84107. E-mail address for J.G. Skedros: jskedros@utahboneandjoint.com
Investigation performed at the Utah Bone and Joint Center, Salt Lake City, Utah

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Nov 16;93(22):e131 1-5. doi: 10.2106/JBJS.J.01954
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Extract

Scapular winging typically results from serratus anterior dysfunction caused by injury to the long thoracic nerve or from trapezius dysfunction caused by injury to the spinal accessory nerve1,2. The surgical treatment of choice for scapular winging caused by trapezius palsy is the Eden-Lange procedure3,4. This procedure, as modified by Bigliani et al.3,5, includes transfer of the levator scapulae muscle laterally to the scapular spine, and lateral transfer of the rhomboid minor and major muscles to the supraspinatus and infraspinatus fossae, respectively. (In the “standard” procedure, the rhomboid minor and major muscles are both transferred to the infraspinatus fossa.) Many studies have documented the success of the modified and standard Eden-Lange procedures in eliminating scapular winging by restoring the major actions of a flaccid trapezius3-9. However, to our knowledge, there are no reports of patients who had an Eden-Lange procedure performed in the setting of a concurrent chronic, large rotator cuff tear with glenohumeral arthritis (rotator cuff-tear arthropathy [RCTA]). We report on a patient with RCTA that evolved from minimally symptomatic to substantially symptomatic after he developed ipsilateral trapezius palsy as the result of a radical neck dissection for thyroid cancer; we describe the use of the Eden-Lange procedure in this patient with advanced rotator cuff disease. The patient was informed that data concerning his case would be submitted for publication, and he provided his consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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