Dramis Asterios, Pimpalnerkar Ashvin
Royal Centre for Defence Medicine, Birmingham, UK.
Acta Orthop Belg. 2005 Jun;71(3):269-72.
Entrapment neuropathy of the suprascapular nerve (SNE), although a recognised clinical entity, is a relatively rare cause of shoulder pain and subjective weakness in the athlete involved in overhead sports like volleyball and badminton. This study deals with the presentation and management of four unusual cases of suprascapular nerve entrapment in volleyball players. Four male volleyball players presented to our department with intractable shoulder pain and subjective sensation of shoulder weakness. They all had visible wasting of both supraspinatus and infraspinatus muscles, together with weakness of abduction and external rotation of the arm. They all responded temporarily to a diagnostic injection of local anaesthetic. MR imaging was useful in diagnosing space occupying lesions in three cases and the presence of a hypertrophic suprascapular ligament in one case. Due to failure of non- operative treatment, which included activity modification, rest, analgesics and rehabilitation programme over 6 months, surgery was then required to decompress the suprascapular nerve. All patients were symptom free at 6 months postoperatively and after an intensive rehabilitation programme, they were able to return to their normal level of activity including sport.
肩胛上神经卡压症(SNE)虽是一种已被认知的临床病症,但在从事排球和羽毛球等上肢运动的运动员中,它是导致肩部疼痛和主观无力的相对罕见原因。本研究探讨了排球运动员中四例不寻常的肩胛上神经卡压症的表现及治疗。四名男性排球运动员因顽固性肩部疼痛和肩部无力的主观感觉前来我院就诊。他们均可见冈上肌和冈下肌萎缩,同时伴有手臂外展和外旋无力。他们对诊断性局部麻醉注射均有暂时反应。磁共振成像(MR)对三例占位性病变的诊断及一例肩胛上韧带肥厚的诊断很有用。由于包括6个月以上的活动调整、休息、止痛药物及康复计划在内的非手术治疗失败,随后需要进行手术以松解肩胛上神经。所有患者术后6个月均无症状,经过强化康复计划后,他们能够恢复到包括运动在内的正常活动水平。