PREVIOUSLY UNREPORTED SHOULDER DEFORMITY FOLLOWING RIGHT LATERAL THORACOTOMY FOR ESOPHAGEAL ATRESIA

An ugly elevated shoulder deformity is reported in 18 children following thoracotomy for esophageal atresia as neonates. The shoulder deformity has not been previously reported. The evolution of the thoracotomy incision used today for the repair of esophageal atresia is traced. The inexplicable use in a number of these patients of a nonstandard thoracotomy incision is discussed. Attention is drawn to the importance of the key muscle, the serratus anterior, which is partially denervated in the thoracotomy incision used and which causes the major part of the deformity. The latissimus dorsi contributes to the deformity especially if divided above the myoneural junction of nerve to the latissimus dorsi. Modification in the standard thoracotomy incision is described in order to prevent the deformity, as treatment of the established deformity is intractable. © 1970.