Koga Ryuji, Furushima Kozo, Kusano Hiroshi, Hamada Junichiro, Itoh Yoshiyasu
Orthopedics. 2017 Jul 1;40(4):e714-e716. doi: 10.3928/01477447-20170117-06. Epub 2017 Jan 23.
Quadrilateral space syndrome (QSS) is the term used to describe axillary nerve palsy due to compression of the axillary nerve and posterior circumflex artery in the quadrilateral space. The precise pathophysiology of QSS is still unclear; hence, a consensus of diagnosis and treatment for QSS has not yet been achieved. The authors present the case of a 17-year-old male baseball player with symptoms of QSS, including right elbow and shoulder joint pain and upper limb numbness while throwing. The symptoms had worsened during baseball. Conservative management for 3 months failed to resolve the symptoms, so surgery was performed. Axillary nerve decompression resulted in functional improvement. The cause of QSS has been previously reported to be fibrous bands, the long head of the triceps, and Bennett lesions. However, the cause of QSS in this case was compression of the axillary nerve between the proximal humerus and the tendinous attachment of the latissimus dorsi. The authors incised a 10- to 15-mm segment of the medial edge of the tendinous insertion of the latissimus dorsi, which resulted in resolution of QSS symptoms. [Orthopedics. 2017; 40(4):e714-e716.].
四边形空间综合征（QSS）是用于描述因四边形空间内腋神经和旋肱后动脉受压导致腋神经麻痹的术语。QSS的确切病理生理学仍不清楚；因此，尚未达成QSS的诊断和治疗共识。作者报告了一例17岁男性棒球运动员出现QSS症状的病例，包括在投球时右肘和肩关节疼痛以及上肢麻木。这些症状在棒球运动期间加重。保守治疗3个月未能缓解症状，因此进行了手术。腋神经减压导致功能改善。先前报道QSS的病因是纤维带、肱三头肌长头和贝内特病变。然而，该病例中QSS的病因是肱骨近端与背阔肌腱性附着点之间对腋神经的压迫。作者切开了背阔肌腱性插入部内侧边缘10至15毫米的一段，这使得QSS症状得到缓解。[《骨科》。2017年；40(4):e714 - e716。]
