Department of Bio-, Electro- and Mechanical Systems (BEAMS), Faculty of Applied Sciences, Université Libre de Bruxelles, Av. Fr. Roosevelt 50, B1050 Brussels, Belgium.
Clin Rheumatol. 2013 Apr;32(4):501-6. doi: 10.1007/s10067-013-2185-7. Epub 2013 Feb 10.
A female professional orchestra violin player, age 54, with an 8-year history of severe left shoulder problems, presented with reproducible, acute, incapacitating left shoulder pain when playing the lowest violin string. This complaint was found caused by compensatory left arm positions for unnoticed finger extensor excursion limitations in a well-healed scar bed from two dorsal wrist ganglion operations 11 and 13 years before. Immediately after extensor tendon mobilization in the scar bed, the patient could assume a normal playing position, which was pain free, and could return to orchestral duties without further major shoulder complaints (follow-up of 10 years). The case study presents finger extensor excursion limitations at the wrist as an unusual extra-regional risk factor for a shoulder complaint and analyses the biomechanics linking these limitations to the complaint. The case illustrates the importance of long-term post-operative hand surgery rehabilitation in musicians.
一位 54 岁的女性职业管弦乐队小提琴手，有 8 年严重左肩问题的病史，在演奏最低音小提琴弦时出现可重现的、急性的、使人丧失能力的左肩疼痛。这一抱怨被发现是由补偿性的左臂位置引起的，原因是手指伸肌在愈合良好的疤痕床上的伸展度有限，而疤痕床是由两次背侧腕关节腱鞘囊肿手术引起的，这两次手术分别发生在 11 年前和 13 年前。在疤痕床上的伸肌腱松解术后，患者可以采取正常的演奏姿势，且无痛，无需进一步的肩部重大投诉即可重返管弦乐队工作（随访 10 年）。该病例研究提出了手指伸肌在腕部的伸展度有限是肩部投诉的一个不常见的区域性外风险因素，并分析了将这些限制与投诉联系起来的生物力学。该病例说明了手外科手术后长期康复对音乐家的重要性。
