McClelland Damian, Paxinos Anastasios
University Hospital of North Staffordshire, Staffordshire, United Kingdom.
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1):162-4. doi: 10.1016/j.jse.2007.05.013. Epub 2007 Nov 12.
Quadrilateral space syndrome is a rare condition in which the contents of the quadrilateral space, the axillary nerve and the posterior circumflex humeral artery, are compressed, leading to vague symptoms of shoulder pain, tenderness over the quadrilateral space on palpation, and teres minor and deltoid denervation. Fibrous bands within the quadrilateral space are often cited in the literature as a cause of compression in quadrilateral space syndrome; however, Cahill and Palmer did not see these bands in cadaveric dissection. These are postulated to cause compression of the quadrilateral space contents in abduction and external rotation of the shoulder. To clarify the anatomic features that may predispose the development of quadrilateral space syndrome, 16 cadaveric shoulders were studied. Dissection revealed that fibrous bands are a common finding in the quadrilateral space, being present in 14 of 16 shoulders. The most common site for a fibrous band was between the teres major and the long head of the triceps. Where the bands were present, both internal and external rotation of the shoulder caused a reduction in the cross-sectional area of the quadrilateral space.
四边孔综合征是一种罕见病症，其中四边孔的内容物，即腋神经和旋肱后动脉，受到压迫，导致肩部疼痛症状不明确、触诊四边孔时有压痛，以及小圆肌和三角肌失神经支配。文献中常将四边孔内的纤维带列为四边孔综合征的压迫原因；然而，卡希尔和帕尔默在尸体解剖中并未发现这些纤维带。据推测，这些纤维带在肩部外展和外旋时会导致四边孔内容物受压。为了阐明可能易患四边孔综合征的解剖学特征，对16具尸体肩部进行了研究。解剖显示，纤维带在四边孔中很常见，16个肩部中有14个存在纤维带。纤维带最常见的位置是在大圆肌和肱三头肌长头之间。在有纤维带的部位，肩部的内旋和外旋都会导致四边孔横截面积减小。
