{"id":7362,"date":"2026-11-03T13:05:45","date_gmt":"2026-11-03T13:05:45","guid":{"rendered":"https:\/\/kamranaghayev.com\/?p=7362"},"modified":"2026-11-03T16:09:09","modified_gmt":"2026-11-03T16:09:09","slug":"kanatli-skapula","status":"publish","type":"post","link":"https:\/\/kamranaghayev.com\/tr\/kanatli-skapula\/","title":{"rendered":"Kanatl\u0131 skapula: nedeni bulmak ve tedaviyi se\u00e7mek"},"content":{"rendered":"\n

Kanatl\u0131 skapula, g\u00f6\u011f\u00fcs duvar\u0131 \u00fczerinde d\u00fczg\u00fcnce kaymas\u0131 gereken k\u00fcrek kemi\u011finin g\u00f6\u011f\u00fcs duvar\u0131ndan ayr\u0131larak d\u0131\u015far\u0131 do\u011fru kalkmas\u0131d\u0131r.<\/strong> Bu durum dinlenirken ya da yaln\u0131zca kol hareket etti\u011finde g\u00f6r\u00fclebilir. Baz\u0131 ki\u015filerde g\u00fc\u00e7s\u00fczl\u00fck, \u00e7abuk yorulma, a\u011fr\u0131 ya da kolu ba\u015f hizas\u0131n\u0131n \u00fczerine kald\u0131rmakta zorluk da olur. G\u00f6r\u00fcn\u00fcm tek ba\u015f\u0131na bir tan\u0131 de\u011fil, bir bulgudur. Egzersizin, izlemenin ya da ameliyat\u0131n yard\u0131mc\u0131 olup olamayaca\u011f\u0131n\u0131, hangi kas\u0131n, sinirin ya da ba\u015fka bir yap\u0131n\u0131n etkilendi\u011fini bilmek belirler.1<\/a>, 2<\/a><\/sup><\/p>\n\n\n\n

Hekimler buna skapular kanatlanma ya da k\u00fcrek kemi\u011fi kanatlanmas\u0131 da der. \u0130ki tarafta hafif\u00e7e belirgin olan ve g\u00fc\u00e7s\u00fczl\u00fckle birlikte olmayan bir k\u00fcrek kemi\u011fi, ki\u015finin v\u00fccut yap\u0131s\u0131n\u0131n bir par\u00e7as\u0131 olabilir. Tek tarafta s\u00fcren kanatlanma ise, \u00f6zellikle g\u00fc\u00e7s\u00fczl\u00fck ya da a\u011fr\u0131yla birlikteyse, do\u011fru bir de\u011ferlendirme gerektirir.<\/p>\n\n\n\n

Bu yaz\u0131da:<\/strong> Nedenleri<\/a> \u00b7 De\u011ferlendirme<\/a> \u00b7 Tedavi<\/a> \u00b7 Ameliyat<\/a> \u00b7 \u0130yile\u015fme<\/a> \u00b7 Torasik outlet sendromuyla ili\u015fkisi<\/a> \u00b7 Uzman g\u00f6r\u00fc\u015f\u00fc almak<\/a><\/p>\n\n\n\n

K\u00fcrek kemi\u011fi neden d\u0131\u015far\u0131 \u00e7\u0131kabilir?<\/h2>\n\n\n\n

K\u00fcrek kemi\u011fini (skapula) kaburgalara ba\u011flayan bir eklem yoktur. Onu yerinde tutan ve kol hareket ettik\u00e7e y\u00f6nlendiren kaslard\u0131r. Bu kaslardan biri zay\u0131flad\u0131\u011f\u0131nda ya da omuzun veya g\u00f6\u011f\u00fcs duvar\u0131n\u0131n \u015feklini de\u011fi\u015ftiren bir durum oldu\u011funda k\u00fcrek kemi\u011fi kaburgalardan ayr\u0131labilir. Hekimlerin ilk olarak ara\u015ft\u0131rd\u0131\u011f\u0131 iki nedenin ikisi de bir siniri ilgilendirir.<\/p>\n\n\n\n

Uzun torasik sinir ve serratus anterior kas\u0131<\/h3>\n\n\n\n

Serratus anterior (\u00f6n di\u015fli kas) g\u00f6\u011f\u00fcs duvar\u0131n\u0131n yan taraf\u0131nda yer al\u0131r ve k\u00fcrek kemi\u011finin kaburgalara bakan y\u00fcz\u00fcne yap\u0131\u015f\u0131r. K\u00fcrek kemi\u011fini kaburgalara yaslanm\u0131\u015f tutar ve kol kalkarken onu d\u00f6nd\u00fcr\u00fcr. Bu kas\u0131n siniri olan uzun torasik sinir, g\u00f6\u011fs\u00fcn yan taraf\u0131 boyunca uzun bir yol izler. Kas zay\u0131flad\u0131\u011f\u0131nda genellikle k\u00fcrek kemi\u011finin i\u00e7 kenar\u0131 s\u0131rttan d\u0131\u015far\u0131 do\u011fru kalkar; bu \u00e7o\u011fu zaman en a\u00e7\u0131k bi\u00e7imde duvara do\u011fru iterken ya da kolu \u00f6ne kald\u0131r\u0131rken g\u00f6r\u00fcl\u00fcr.1<\/a>, 2<\/a><\/sup><\/p>\n\n\n\n

S\u0131k g\u00f6r\u00fclen bir neden n\u00f6raljik amiyotrofidir (Parsonage\u2013Turner sendromu olarak da bilinir). Bu iltihabi sinir hastal\u0131\u011f\u0131 tipik olarak omuzda aniden ba\u015flayan \u015fiddetli bir a\u011fr\u0131yla ba\u015flar; a\u011fr\u0131 azal\u0131rken g\u00fcnler ya da haftalar sonra g\u00fc\u00e7s\u00fczl\u00fck ortaya \u00e7\u0131kar. Di\u011fer nedenler aras\u0131nda yaralanma, omuzun tekrarlayan ya da a\u011f\u0131r kullan\u0131m\u0131na ba\u011fl\u0131 zorlanma, sinirin ge\u00e7ti\u011fi yolun yak\u0131n\u0131nda yap\u0131lan ameliyatlar ve daha seyrek olarak sinirin yolu boyunca bir s\u0131k\u0131\u015fma say\u0131labilir.14<\/a><\/sup> Klinik muayene ve elektriksel testlere dayanan geni\u015f bir seride, tek tarafl\u0131 kanatlanman\u0131n en s\u0131k nedeni uzun torasik sinir sorunlar\u0131yd\u0131 ve bunlar\u0131n \u00e7o\u011fu n\u00f6raljik amiyotrofiyle ili\u015fkiliydi.1<\/a><\/sup><\/p>\n\n\n\n

Spinal aksesuar sinir ve trapez kas\u0131<\/h3>\n\n\n\n

Trapez kas\u0131, omuzun \u00fcst k\u0131sm\u0131 ve s\u0131rt\u0131n \u00fcst b\u00f6l\u00fcm\u00fc boyunca uzanan, deriye yak\u0131n b\u00fcy\u00fck bir kast\u0131r. Omuzu yukar\u0131da tutar ve kol yana kald\u0131r\u0131l\u0131rken k\u00fcrek kemi\u011finin kontrol\u00fcne yard\u0131m eder. Bu kas\u0131n siniri olan spinal aksesuar sinir (11. kafa \u00e7ifti), boynun yan taraf\u0131nda deriye yak\u0131n seyreder ve burada, en s\u0131k lenf bezi biyopsisi gibi ameliyatlar s\u0131ras\u0131nda zarar g\u00f6rebilir.4<\/a><\/sup><\/p>\n\n\n\n

Trapez kas\u0131n\u0131n zay\u0131fl\u0131\u011f\u0131 tipik olarak omuzun d\u00fc\u015fmesine, k\u00fcrek kemi\u011finin a\u015fa\u011f\u0131 ve d\u0131\u015fa do\u011fru kaymas\u0131na ve kolu yana kald\u0131rmakta zorlu\u011fa yol a\u00e7ar. \u00c7o\u011fu zaman a\u011fr\u0131l\u0131d\u0131r. Geni\u015f bir cerrahi seride hastalar\u0131n \u00e7o\u011fu a\u011fr\u0131l\u0131 omuz i\u015flev kayb\u0131 nedeniyle y\u00f6nlendirilmi\u015fti ve bir\u00e7o\u011fu ge\u00e7 y\u00f6nlendirilmi\u015fti.4<\/a><\/sup> \u00c7ok seyrek olarak sinir daha yukar\u0131da, kafa taban\u0131na yak\u0131n bir yerde s\u0131k\u0131\u015f\u0131r. Bu, se\u00e7ilmi\u015f hastalarda akla getirilmesi gereken nadir bir olas\u0131l\u0131kt\u0131r; kanatl\u0131 skapulan\u0131n ola\u011fan a\u00e7\u0131klamas\u0131 de\u011fildir.11<\/a><\/sup><\/p>\n\n\n\n

Di\u011fer nedenler<\/h3>\n\n\n\n

Kanatlanma romboid kaslar\u0131n zay\u0131fl\u0131\u011f\u0131ndan, fasiyoskapulohumeral musk\u00fcler distrofi gibi kas hastal\u0131klar\u0131ndan, boyun ya da brakiyal pleksus sinirlerinin sorunlar\u0131ndan, omuz yaralanmalar\u0131ndan ya da kemik \u00e7\u0131k\u0131nt\u0131lar\u0131 ve di\u011fer yap\u0131sal de\u011fi\u015fikliklerden de kaynaklanabilir. Baz\u0131 gen\u00e7ler k\u00fcrek kemi\u011fini isteyerek kanatland\u0131rabilir. Bu nedenlerin her biri farkl\u0131 bir bak\u0131m gerektirir; bu y\u00fczden g\u00f6r\u00fcn\u00fcm tek ba\u015f\u0131na yeterli de\u011fildir.1<\/a>, 2<\/a><\/sup><\/p>\n\n\n\n

Hekimler kanatlanmay\u0131 skapular diskineziden de ay\u0131r\u0131r. Skapular diskinezi, k\u00fcrek kemi\u011finin hareket bi\u00e7imindeki bir de\u011fi\u015fikliktir; sinir hasar\u0131 olmadan, \u00e7o\u011fu zaman omuz a\u011fr\u0131s\u0131na ya da omuz instabilitesine e\u015flik eder. Genellikle altta yatan omuz sorunuyla birlikte, hedefe y\u00f6nelik bir rehabilitasyonla tedavi edilir.3<\/a><\/sup><\/p>\n\n\n\n

Neden nas\u0131l bulunur?<\/h2>\n\n\n\n

De\u011ferlendirme \u00fc\u00e7 soruya yan\u0131t arar: hangi kas zay\u0131f, neden zay\u0131f ve iyile\u015fiyor mu?<\/p>\n\n\n\n

\u00d6yk\u00fc ve muayene.<\/strong> Hekim sorunun nas\u0131l ba\u015flad\u0131\u011f\u0131n\u0131 (ani a\u011fr\u0131n\u0131n ard\u0131ndan gelen g\u00fc\u00e7s\u00fczl\u00fck, boyun ameliyat\u0131ndan sonra ba\u015flayan g\u00fc\u00e7s\u00fczl\u00fckten farkl\u0131 bir y\u00f6ne i\u015faret eder), nas\u0131l de\u011fi\u015fti\u011fini, kolun neleri yapabildi\u011fini ve yapamad\u0131\u011f\u0131n\u0131, daha \u00f6nce benzer bir durum olup olmad\u0131\u011f\u0131n\u0131 ve ailede g\u00f6r\u00fcl\u00fcp g\u00f6r\u00fclmedi\u011fini sorar. Muayenede k\u00fcrek kemi\u011fi farkl\u0131 hareketler s\u0131ras\u0131nda izlenir, kaslar tek tek test edilir, kas erimesi ve di\u011fer n\u00f6rolojik bulgular aran\u0131r. Muayene yaln\u0131zca g\u00f6r\u00fcnen k\u00fcrek kemi\u011fini de\u011fil, omuzu ve boynu da kapsar.1<\/a>, 2<\/a><\/sup><\/p>\n\n\n\n

Elektromiyografi (EMG) ve sinir iletim \u00e7al\u0131\u015fmalar\u0131.<\/strong> Bu testler bir sinirin mi yoksa kas\u0131n kendisinin mi etkilendi\u011fini ve ne \u00f6l\u00e7\u00fcde etkilendi\u011fini g\u00f6sterir. Kanatlanmada do\u011fru kaslar\u0131n test edilmesi gerekir: kol i\u00e7in yap\u0131lan rutin bir \u00e7al\u0131\u015fma soruyu yan\u0131tlamayabilir. Sonu\u00e7lar, testin zamanlamas\u0131 ve testi yapan ki\u015fi soruna uygun oldu\u011funda en yararl\u0131d\u0131r. Tan\u0131y\u0131 destekler; ancak tek ba\u015f\u0131na bir ameliyat\u0131n ne kadar i\u015fe yarayaca\u011f\u0131n\u0131 \u00f6ng\u00f6rmez.1<\/a><\/sup><\/p>\n\n\n\n

G\u00f6r\u00fcnt\u00fcleme.<\/strong> Tetkikler d\u00fc\u015f\u00fcn\u00fclen nedene g\u00f6re se\u00e7ilir: \u00f6rne\u011fin boynu, omuzu, olas\u0131 bir kemik \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131 ya da kaslar\u0131n kendisini incelemek i\u00e7in. Kas ultrasonu, EMG’yi tamamlayan bir y\u00f6ntem olarak ara\u015ft\u0131r\u0131lmaktad\u0131r. Kanatlanmas\u0131 olan herkesin \u00e7ektirmesi gereken tek bir tetkik yoktur.9<\/a><\/sup><\/p>\n\n\n\n

Zamanlama.<\/strong> Yeni ba\u015flayan ya da artan g\u00fc\u00e7s\u00fczl\u00fck, \u00f6zellikle boyun, g\u00f6\u011f\u00fcs ya da omuz ameliyat\u0131ndan sonra ortaya \u00e7\u0131km\u0131\u015fsa, gecikmeden de\u011ferlendirilmelidir. Kesilmi\u015f olabilecek bir sinir, onar\u0131m h\u00e2l\u00e2 bir se\u00e7enekken erken fark edilmelidir. \u0130yile\u015fmenin beklendi\u011fi durumlarda, n\u00f6raljik amiyotrofide s\u0131k oldu\u011fu gibi, d\u00fczenli yeniden de\u011ferlendirmeyle birlikte bir s\u00fcre izlemek gecikme de\u011fil, iyi bak\u0131m\u0131n bir par\u00e7as\u0131d\u0131r.4<\/a>, 5<\/a><\/sup><\/p>\n\n\n\n

Tedavi nedene ba\u011fl\u0131d\u0131r<\/h2>\n\n\n\n

Kanatlanmas\u0131 olan ki\u015filerin \u00e7o\u011fu ameliyat d\u0131\u015f\u0131 tedaviyle ba\u015flar. Bu; tan\u0131y\u0131 anlamak, a\u011fr\u0131y\u0131 y\u00f6netmek, bir s\u00fcre a\u011f\u0131r ya da ba\u015f \u00fcst\u00fc i\u015flere ara vermek ve etkilenen kasa g\u00f6re planlanm\u0131\u015f bir rehabilitasyon anlam\u0131na gelir. Bir fizyoterapist, sinir iyile\u015firken h\u00e2l\u00e2 \u00e7al\u0131\u015fan kaslar\u0131 g\u00fc\u00e7lendirebilir, omuz kontrol\u00fcn\u00fc geli\u015ftirebilir ve eklemin hareketlili\u011fini koruyabilir. Bir omuz yaralanmas\u0131 i\u00e7in haz\u0131rlanm\u0131\u015f program, sinir deste\u011fini kaybetmi\u015f bir kas i\u00e7in haz\u0131rlanan programla ayn\u0131 de\u011fildir; bu nedenle tan\u0131 netle\u015ftikten sonra ba\u015flamak yararl\u0131d\u0131r.3<\/a>, 6<\/a><\/sup><\/p>\n\n\n\n

Bir\u00e7ok sinir sorunu aylar i\u00e7inde d\u00fczelir. Yaln\u0131zca izlenen, izole serratus felci olan ki\u015filerin uzun s\u00fcreli takibinde kanatlanma \u00e7o\u011funda d\u00fczeldi; bu, ba\u015flang\u0131\u00e7tan ortalama yakla\u015f\u0131k 16 ay sonra oldu. Hareket de \u00e7o\u011funda geri geldi. A\u011fr\u0131, g\u00f6r\u00fcnen kanatlanmaya g\u00f6re daha s\u0131k s\u00fcrd\u00fc; bu da g\u00f6r\u00fcn\u00fcm\u00fcn, a\u011fr\u0131n\u0131n ve g\u00fcc\u00fcn farkl\u0131 bi\u00e7imlerde iyile\u015febilece\u011fini hat\u0131rlat\u0131r. \u0130yile\u015fme tahminleri \u00e7al\u0131\u015fmalar aras\u0131nda b\u00fcy\u00fck farkl\u0131l\u0131k g\u00f6sterir.5<\/a>, 6<\/a><\/sup><\/p>\n\n\n\n

Yeniden de\u011ferlendirme ilk muayene kadar \u00f6nemlidir. G\u00fc\u00e7 beklendi\u011fi gibi geri gelmiyorsa ya da tan\u0131 de\u011fi\u015firse, plan da de\u011fi\u015fmelidir.<\/p>\n\n\n\n

Ameliyat ne zaman konu\u015fulabilir?<\/h2>\n\n\n\n

Ameliyat, belirli bir sorun ortaya kondu\u011funda ve ameliyat d\u0131\u015f\u0131 tedavinin yeterli olmas\u0131 beklenmedi\u011finde d\u00fc\u015f\u00fcn\u00fcl\u00fcr: \u00f6rne\u011fin kesilmi\u015f ya da iyile\u015fmeyen bir sinir veya omuzu k\u0131s\u0131tlayan kal\u0131c\u0131 bir g\u00fc\u00e7s\u00fczl\u00fck. “Kanatl\u0131 skapula ameliyat\u0131”, farkl\u0131 ama\u00e7lar\u0131 olan birka\u00e7 ayr\u0131 ameliyat\u0131 kapsar:6<\/a>, 14<\/a><\/sup><\/p>\n\n\n\n

Ameliyat<\/th>Amac\u0131<\/th><\/tr><\/thead>
Sinirin serbestle\u015ftirilmesi (n\u00f6roliz ya da dekompresyon)<\/td>Sorunun bu oldu\u011fu belirlenen se\u00e7ilmi\u015f hastalarda, siniri ona bask\u0131 yapan dokudan kurtarmak<\/td><\/tr>
Sinir onar\u0131m\u0131, sinir grefti ya da sinir transferi<\/td>Bir yaralanmadan sonra, zamanlama ve kas\u0131n durumu uygunsa sinir sinyalleri i\u00e7in yeniden bir yol olu\u015fturmak<\/td><\/tr>
Tendon ya da kas transferi<\/td>As\u0131l sinir iyile\u015fmeyecekse, zay\u0131f kas\u0131n g\u00f6revini \u00e7al\u0131\u015fan bir kasa devretmek<\/td><\/tr>
K\u00fcrek kemi\u011finin kaburgalara sabitlenmesi (skapulotorasik f\u00fczyon)<\/td>Baz\u0131 kas hastal\u0131klar\u0131nda ya da di\u011fer tedaviler i\u015fe yaramad\u0131\u011f\u0131nda oldu\u011fu gibi se\u00e7ilmi\u015f durumlarda, bir miktar hareket kayb\u0131 pahas\u0131na k\u00fcrek kemi\u011fini sabitlemek<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Bu ameliyatlar birbirinin yerine kullan\u0131lamaz. Sinirin serbestle\u015ftirilmesi kesilmi\u015f bir siniri onarmaz; tendon transferi de as\u0131l siniri geri getirmez. Transferler kasa g\u00f6re de farkl\u0131d\u0131r: serratus zay\u0131fl\u0131\u011f\u0131nda ve trapez zay\u0131fl\u0131\u011f\u0131nda kullan\u0131lan ameliyatlar ayn\u0131 de\u011fildir.<\/p>\n\n\n\n

Yay\u0131mlanm\u0131\u015f kan\u0131tlar\u0131n \u00e7o\u011fu, uzman merkezlerden gelen k\u00fc\u00e7\u00fck serilerdir. Bir seride, ameliyat d\u0131\u015f\u0131 tedaviyle d\u00fczelmeyen izole serratus felci olan 29 ki\u015fide uzun torasik sinir serbestle\u015ftirildi ve \u00e7o\u011funda kanatlanma azald\u0131. Serratus felcinde tendon transferiyle ilgili uzun s\u00fcreli bir \u00e7al\u0131\u015fmada, omuz i\u015flevindeki kazan\u0131m uzun y\u0131llar s\u00fcrd\u00fc; ancak ilk d\u00f6nemdeki en y\u00fcksek d\u00fczeyin alt\u0131na indi. Bu sonu\u00e7lar belirli merkezlerdeki se\u00e7ilmi\u015f hastalar\u0131 anlat\u0131r; kanatl\u0131 skapula ameliyat\u0131 i\u00e7in tek bir ba\u015far\u0131 oran\u0131 vermez.7<\/a>, 8<\/a><\/sup><\/p>\n\n\n\n

Bir ameliyat\u0131 kabul etmeden \u00f6nce \u015funlar\u0131 sormak yerindedir: ameliyat hangi kas\u0131 ve siniri hedefliyor, neyi iyile\u015ftirmesi bekleniyor, neyi de\u011fi\u015ftirmeyecek, ba\u015fl\u0131ca riskleri neler ve rehabilitasyon ne kadar s\u00fcrecek?<\/p>\n\n\n\n

\u0130yile\u015fme ve sizi neler bekliyor<\/h2>\n\n\n\n

Sinir sorunlar\u0131ndan ve ameliyatlardan sonra iyile\u015fme genellikle aylarla \u00f6l\u00e7\u00fcl\u00fcr. G\u00f6r\u00fcn\u00fcm, a\u011fr\u0131, g\u00fc\u00e7 ve ba\u015f \u00fcst\u00fc \u00e7al\u0131\u015fabilme farkl\u0131 h\u0131zlarda ve farkl\u0131 \u00f6l\u00e7\u00fclerde d\u00fczelebilir; bu y\u00fczden sizin i\u00e7in en \u00f6nemli hedefler \u00fczerinde ba\u015ftan anla\u015fmak yararl\u0131d\u0131r. Rehabilitasyon her ameliyattan sonra s\u00fcrer ve kontroller yaln\u0131zca k\u00fcrek kemi\u011finin g\u00f6r\u00fcn\u00fcm\u00fcn\u00fc de\u011fil, i\u015flevi de de\u011ferlendirmelidir.5<\/a>, 6<\/a>, 8<\/a><\/sup><\/p>\n\n\n\n

Uzman g\u00f6r\u00fc\u015f\u00fc almak<\/h2>\n\n\n\n

Do\u00e7. Dr. Kamran Aghayev, \u0130stanbul’da \u00e7al\u0131\u015fan bir beyin ve sinir cerrah\u0131d\u0131r. Yay\u0131mlanm\u0131\u015f \u00e7al\u0131\u015fmalar\u0131 aras\u0131nda n\u00f6rojenik torasik outlet sendromu ameliyatlar\u0131na ili\u015fkin bir klinik seri ve omuza ve kola giden sinir a\u011f\u0131 olan brakiyal pleksusa cerrahi eri\u015fim \u00fczerine, ortak yazar\u0131 oldu\u011fu bir anatomi \u00e7al\u0131\u015fmas\u0131 bulunur.12<\/a>, 13<\/a><\/sup> Do\u00e7. Dr. Aghayev’in \u00f6zge\u00e7mi\u015fi ve yay\u0131nlar\u0131<\/a> hakk\u0131nda daha fazla bilgi alabilirsiniz.<\/p>\n\n\n\n

S\u00fcren bir kanatlanman\u0131z ya da omuz g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fcn\u00fcz varsa ve bir g\u00f6r\u00fc\u015f almak istiyorsan\u0131z, durumunuzun Do\u00e7. Dr. Aghayev’in \u00e7al\u0131\u015fma alan\u0131na girip girmedi\u011fini sormak i\u00e7in klinikle ileti\u015fime ge\u00e7in. Sorunun nas\u0131l ba\u015flad\u0131\u011f\u0131n\u0131, kolunuzla art\u0131k neleri yapamad\u0131\u011f\u0131n\u0131z\u0131 ve \u015fimdiye kadar ald\u0131\u011f\u0131n\u0131z tedaviyi anlat\u0131n. Varsa mevcut doktor raporlar\u0131 ve sinir testi ya da g\u00f6r\u00fcnt\u00fcleme sonu\u00e7lar\u0131, klini\u011fin size uygun randevuyu \u00f6nermesine yard\u0131mc\u0131 olur. Yeni ba\u015flayan ya da artan g\u00fc\u00e7s\u00fczl\u00fck, seyahat beklenmeden bulundu\u011funuz yerde de\u011ferlendirilmelidir.<\/p>\n\n\n\n

Online dan\u0131\u015fmanl\u0131k talep edebilir<\/a> ya da \u0130stanbul’da randevu alabilirsiniz<\/a>.<\/p>\n\n\n\n

Kaynaklar<\/h2>\n\n\n\n

1. Seror et al. Unilateral winged scapula: clinical and electrodiagnostic experience with 128 cases, with special attention to long thoracic nerve palsy<\/a>. Muscle & Nerve, 2018. Referral series over 25 years.<\/p>\n\n\n\n

2. Ng and Wu. Scapular winging secondary to serratus anterior dysfunction: analysis of clinical presentations and etiology in a consecutive series of 96 patients<\/a>. Journal of Shoulder and Elbow Surgery, 2021. Consecutive specialist series.<\/p>\n\n\n\n

3. Kibler et al. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the “Scapular Summit”<\/a>. British Journal of Sports Medicine, 2013. Expert consensus.<\/p>\n\n\n\n

4. Camp and Birch. Injuries to the spinal accessory nerve: a lesson to surgeons<\/a>. Journal of Bone and Joint Surgery (British volume), 2011. Series of 111 patients.<\/p>\n\n\n\n

5. Pikkarainen et al. The natural course of serratus palsy at 2 to 31 years<\/a>. Clinical Orthopaedics and Related Research, 2013. 37 patients followed without surgery.<\/p>\n\n\n\n

6. Geurkink et al. Treatment of neurogenic scapular winging: a systematic review on outcomes after nonsurgical management and tendon transfer surgery<\/a>. Journal of Shoulder and Elbow Surgery, 2023. Systematic review of low- to moderate-quality studies.<\/p>\n\n\n\n

7. Ng et al. Neurolysis of the long thoracic nerve for scapular winging due to isolated serratus anterior palsy: early and midterm results in 29 patients<\/a>. Journal of Hand and Microsurgery, 2024. Retrospective series.<\/p>\n\n\n\n

8. Geurkink et al. Long-term outcomes of pectoralis major transfer for scapular winging due to long thoracic nerve palsy: results after a median follow-up of 17 years<\/a>. JSES International, 2024. Small long-term cohort.<\/p>\n\n\n\n

9. Rardin et al. Combined use of EMG and muscle ultrasound for the evaluation of scapular winging<\/a>. Muscle & Nerve, 2026. Small retrospective study.<\/p>\n\n\n\n

10. El Haj et al. The association of long thoracic nerve variants with medial scapular winging in thoracic outlet syndrome: a clinical and anatomical study<\/a>. Journal of Hand Surgery, 2026; online 2025. Association within a surgical TOS cohort.<\/p>\n\n\n\n

11. Mitchell et al. “Winged” Eagle’s syndrome: neurophysiological findings in a rare cause of spinal accessory nerve palsy<\/a>. Journal of Neurosurgery: Case Lessons, 2023. Two patients.<\/p>\n\n\n\n

12. Aghayev. Safety and efficacy of posterior upper rib excision and decompression technique for surgical treatment of neurogenic thoracic outlet syndrome<\/a>. World Neurosurgery, 2023. Retrospective series.<\/p>\n\n\n\n

13. Akaslan et al. Surgical anatomy of the posterior intermuscular approach to the brachial plexus<\/a>. Hand, 2021; online 2020. Cadaver study; Dr. Aghayev is a co-author.<\/p>\n\n\n\n

14. Wu and Ng. Long thoracic nerve palsy: when is decompression indicated<\/a>. Journal of Hand Surgery Global Online, 2023. Clinical review.<\/p>\n\n\n\n

15. Al-Shekhlee and Katirji. Spinal accessory neuropathy, droopy shoulder, and thoracic outlet syndrome<\/a>. Muscle & Nerve, 2003. Two patients.<\/p>\n","protected":false},"excerpt":{"rendered":"

K\u00fcrek kemi\u011fi neden g\u00f6\u011f\u00fcs duvar\u0131ndan ayr\u0131l\u0131r, etkilenen kas ve sinir nas\u0131l belirlenir ve bu se\u00e7im fizik tedaviyi ya da ameliyat\u0131 nas\u0131l y\u00f6nlendirir.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","ka_reviewed_on":"","ka_updated_on":"","footnotes":""},"categories":[24],"tags":[],"class_list":["post-7362","post","type-post","status-publish","format-standard","hentry","category-hastaliklar"],"acf":[],"_links":{"self":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/7362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/comments?post=7362"}],"version-history":[{"count":2,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/7362\/revisions"}],"predecessor-version":[{"id":7368,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/7362\/revisions\/7368"}],"wp:attachment":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media?parent=7362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/categories?post=7362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/tags?post=7362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}