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The ball entered the right shoulder, immediately over the suprascapular notch, passed superficially upward and forward into the neck, wounding the esophagus posteriorly at a point opposite the thyroid cartilage, and lodged in the left side of the neck. The patient had little hemorrhage, but had expectorated and swallowed much blood.
Regular exercise such as the horse usually takes when at pasture, is very helpful in treating atrophy, and in some cases it has been found that no reasonable amount of irritation would stimulate muscular regeneration; but by later allowing patients to exercise at will, recovery took place in a satisfactory manner. No special attention is ordinarily necessary. Paralysis of the Suprascapular Nerve.
If serious injury is done the nerve so that it undergoes degenerative changes, there will result atrophy of the muscles that derive their nerve supply from the suprascapular nerve. Treatment.
Depending upon the nature and extent of an injury thus inflicted, so the manner in which the affection is manifested varies. The suprascapular nerve is rather frequently injured causing partial or complete loss of function of the structures supplied by this nerve, and abduction of the scapulohumeral joint naturally results.
Later, as soon as acute inflammation has subsided, vesication of a liberal area around the anteroexternal part of the scapulohumeral joint and over the course of the suprascapular nerve, will stimulate recovery in favorable cases. As a rule, in mild cases, the subject is in a condition to return to work in two or three weeks. Radial Paralysis.
With partial or complete suspension of function of the suprascapular nerve there results enervation of the supraspinatus and infraspinatus muscles. Since these muscles act as external lateral ligaments of the scapulohumeral joint, when they are incapacitated, there naturally follows more or less abduction of the shoulder when weight is borne.
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