Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut.
Department of Orthopaedic Surgery, The Cleveland Clinic, Cleveland, Ohio.
JBJS Case Connect. 2020 Oct 26;10(4):e20.00096. doi: 10.2106/JBJS.CC.20.00096.
Two patients presented to different surgeons complaining of persistent shoulder pain after reverse total shoulder arthroplasty. Workups for fracture, instability, and periprosthetic infection were negative. Advanced imaging, nerve conduction studies, and diagnostic injections localized symptoms to the suprascapular nerve. Revision arthroplasty with removal of the offending screws improved pain in both patients.
Suprascapular nerve irritation because of the malposition of baseplate screws in reverse total shoulder arthroplasty can be a source of postoperative pain. Removal of the offending screw without formal nerve exploration may result in symptomatic improvement.
两名患者向不同的外科医生就诊，均主诉在接受反式全肩关节置换术后持续肩部疼痛。对骨折、不稳定和假体周围感染进行了检查，结果均为阴性。高级影像学、神经传导研究和诊断性注射将症状定位在肩胛上神经处。翻修关节置换术并移除有问题的螺钉后，两名患者的疼痛均得到改善。
反式全肩关节置换术后由于底板螺钉位置不当导致肩胛上神经受到刺激，可能是术后疼痛的一个来源。在不进行正式神经探查的情况下移除有问题的螺钉可能会导致症状改善。
