Infraspinatus atrophy due to Bennett lesion causing suprascapular nerve palsy

We report the case of a 19-year-old professional volleyball player who presented with right shoulder pain exacerbated during sports activity. On physical examination, infraspinatus atrophy was evident. As the clinical setting suggested suprascapular nerve entrapment syndrome, shoulder MR and later CT were performed. The results showed radiological signs of subacute-chronic infraspinatus muscle denervation and a Bennett lesion of the shoulder, presumably due to chronic repetitive trauma during the classical overhead swing in volleyball. The patient agreed to surgical treatment, and arthroscopic decompression was achieved. After months of rehabilitation, the pain gradually subsided, the infraspinatus muscle recovered its trophism, and the patient progressively returned to her regular sports activity.

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Acute handlebar syndrome: Two extremes of a challenging diagnosis

Surgical Neurology International ◽

10.25259/sni_606_2020 ◽

2020 ◽

Vol 11 ◽

pp. 366

Author(s):

Fabio Veiga de Castro Sparapani ◽

Marcela Fernandes ◽

Leonardo Favi Bocca ◽

Luis Renato Nakachima ◽

Sergio Cavalheiro

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Ulnar Nerve ◽

Functional Recovery ◽

Short Distance ◽

Nerve Palsy ◽

Ulnar Neuropathy ◽

Case Description ◽

Ulnar Nerve Palsy ◽

Repetitive Trauma

Background: Ulnar nerve mononeuropathy diagnosis can be challenging depending on where neural lesion is present. Repetitive trauma during cycling is a rare cause of ulnar neuropathy. Case Description: We describe two patients who developed the handlebar syndrome, an ulnar nerve palsy at Guyon’s canal after cycling. The first patient had the syndrome after a short-distance ride and she was treated surgically, while the second patient developed the classical syndrome after a long ride and received conservative treatment. Surgical treatment of the first patient led to functional recovery. Conclusion: Handlebar syndrome is a neuropathy caused by extrinsic repetitive compression of ulnar nerve at wrist. Increasing incidence of this disease can be expected after increasing popularity of cycling sports. Avoid of repetitive trauma is the main management goal, with surgical treatment reserved for failure of conservative treatment.

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GLENOID LABRAL CYST PRESENTING WITH SUPRASCAPULAR NERVE PALSY

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703813 ◽

2014 ◽

Vol 04 (03) ◽

pp. 105-108

Author(s):

Siddharth M. Shetty ◽

Rajsankar N. R. ◽

B. Jayaprakash Shetty

Keyword(s):

Nerve Palsy ◽

Muscle Wasting ◽

Supraspinatus Tendon ◽

Suprascapular Nerve ◽

Left Shoulder ◽

Rare Entity ◽

Mri Scan ◽

Compressive Neuropathy ◽

Diagnostic Arthroscopy ◽

Infraspinatus Muscle

Abstract Introduction: Glenoid labral cyst in shoulder is an entity akin to meniscal cysts in knee. It usually manifests with features similar to impingement syndrome or rotator cuff weakness. Clinical Picture: A 42yr old male patient with complaints of left shoulder pain and restriction of movement for 2 months with muscle wasting in left supraspinatus and infraspinatus region. MRI left shoulder showed partial tear of supraspinatus tendon, glenoid labral cyst in closed proximity and causing compression to suprascapular nerve with atrophy of infraspinatus muscle. Treatment: Left shoulder diagnostic arthroscopy was done and followed with ganglion excision done through a posterior approach and suprascapular nerve was decompressed. Histopathology report showed features of an inflammatory cystic lesion. Outcome: patient experienced resolution of symptoms within 4 months of surgery with significant restoration of rotator function and bulk. Conclusion: Suprascapular nerve compressive neuropathy secondary to glenoid labral cyst is a rare entity but easily recognizable on a MRI scan and responds quickly to decompression.

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Arthroscopic Decompression of Suprascapular Nerve for Infraspinatus Muscle Atrophy in Volleyball Player: A Case Report

Orthopedics & Traumatology ◽

10.5035/nishiseisai.60.780 ◽

2011 ◽

Vol 60 (4) ◽

pp. 780-784

Author(s):

Yusei Funakoshi ◽

Hideki Asato ◽

Hideo Kinjo ◽

Mika Takaesu ◽

Fuminori Kanaya

Keyword(s):

Case Report ◽

Muscle Atrophy ◽

Suprascapular Nerve ◽

Volleyball Player ◽

Infraspinatus Muscle

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Isolated Suprascapular Nerve Palsy: a Review of Nine Cases

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100039524 ◽

1995 ◽

Vol 22 (4) ◽

pp. 301-304 ◽

Cited By ~ 20

Author(s):

Henry Berry ◽

Kester Kong ◽

Alan R. Hudson ◽

Richard J. Moulton

Keyword(s):

Nerve Palsy ◽

Muscle Wasting ◽

Cervical Vertebrae ◽

Frozen Shoulder ◽

Suprascapular Nerve ◽

Weight Lifting ◽

Suprascapular Notch ◽

Infraspinatus Muscle ◽

Post Traumatic ◽

Brachial Plexus Neuritis

AbstractBackgroundIn nine patients, suprascapular nerve palsy followed serious accidents associated with fractures of the cervical vertebrae, clavicle or scapula and after weight lifting, wrestling and a fall on the elbow or shoulder.MethodAll patients were examined as to muscle wasting, weakness and shoulder fixation. EMG examination was done in all cases and six patients underwent surgical exploration.ResultsThe palsy was incomplete on clinical and EMG examination in all patients. On exploration, scarring, entrapment, tethering or kinking at the suprascapular notch was found in four and two had post-traumatic neuromas.ConclusionsIn contrast to published studies, none of our patients presented with shoulder pain, a spontaneous onset nor with involvement limited to the infraspinatus muscle. The differential diagnosis should include C5 root lesion, brachial plexus neuritis, frozen shoulder and tear of the rotator cuff.

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Acute isolated suprascapular nerve palsy limited to the infraspinatus muscle: A case report

Archives of Physical Medicine and Rehabilitation ◽

10.1053/apmr.2002.30927 ◽

2002 ◽

Vol 83 (4) ◽

pp. 565-567 ◽

Cited By ~ 12

Author(s):

Sanjay Mittal ◽

Michael Turcinovic ◽

Elaine S. Gould ◽

S.Murthy Vishnubhakat

Keyword(s):

Case Report ◽

Nerve Palsy ◽

Suprascapular Nerve ◽

Infraspinatus Muscle

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Isolated and painless infraspinatus atrophy in top-level volleyball players: report of two cases and review of the literature

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1993000100020 ◽

1993 ◽

Vol 51 (1) ◽

pp. 125-129 ◽

Cited By ~ 19

Author(s):

Célia Harumi Tengan ◽

Acary S. Bulle Oliveira ◽

Beatriz Hitomi Kiymoto ◽

Maria da Penha Ananias Morita ◽

Jovany L. Alves de Medeiros ◽

...

Keyword(s):

Shoulder Joint ◽

Suprascapular Nerve ◽

The Other ◽

Review Of The Literature ◽

Direct Trauma ◽

Distal Branch ◽

Infraspinatus Muscle ◽

Volleyball Players ◽

Intense Activity ◽

Infraspinatus Atrophy

Isolated and painless infraspinatus atrophy and weakness are described in two top-level volleyball players. EMG revealed isolated denervation of the infraspinatus muscle. One athlete continued playing and his clinical features have not changed. The other recovered her muscle bulk and strength after stopping playing. These findings were attributed to intense activity of the shoulder joint, without any direct trauma. On clinical grounds, we did not consider these cases as true examples of entrapment neuropathy. Pathogenesis was related to traction of the distal branch of the suprascapular nerve during the act of reception of the ball («Manchete»).

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Isolated infraspinatus atrophy in elite volleyball player- Understanding the biomechanics, imaging and outcome

Indian Journal of Musculoskeletal Radiology ◽

10.25259/ijmsr_28_2021 ◽

2021 ◽

Vol 3 ◽

pp. 137-139

Author(s):

Nafisa Shakir Batta ◽

Mukul Mittal ◽

Vikas Batra ◽

Vineet Jain Jain

Keyword(s):

Case Report ◽

Upper Extremity ◽

Suprascapular Nerve ◽

Volleyball Player ◽

Overhead Sports ◽

Extremity Injuries ◽

Infraspinatus Atrophy

Over 800 million people worldwide play volleyball, either recreational or competitive. Even though all throwing athletes suffer from upper extremity injuries caused by overuse, volleyball additionally involves certain prototypical throwing biomechanics, not seen in other overhead sports. Complex biomechanics and the balanced interplay between the glenohumeral and scapulothoracic muscles ensure velocity and torque displacement in spike and jump-serve maneuvers (formerly known as smash) which are exclusive to volleyball. In this case report, we have described in detail the entity of isolated infraspinatus atrophy secondary to suprascapular nerve neuropathy.

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Clinical outcome and return to sports activity after surgical treatment for recurrent shoulder instability with a modified Latarjet procedure

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2021.102977 ◽

2021 ◽

pp. 102977

Author(s):

Matthias Aurich ◽

Gunther O. Hofmann ◽

Norman Best

Keyword(s):

Surgical Treatment ◽

Clinical Outcome ◽

Shoulder Instability ◽

Return To Sports ◽

Latarjet Procedure ◽

Sports Activity ◽

Recurrent Shoulder Instability

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Evaluation of suprascapular nerve neurotization after nerve grafting or transfer in the treatment of brachial plexus traction lesions

Neurosurgical FOCUS ◽

10.3171/foc.2004.16.5.14 ◽

2004 ◽

Vol 16 (5) ◽

pp. 1-13

Author(s):

Martijn J. A. Malessy ◽

Godard C. W. de Ruiter ◽

Kees S. de Boer ◽

Ralph T. W. M. Thomeer

Keyword(s):

Brachial Plexus ◽

Muscle Power ◽

Nerve Transfer ◽

Deltoid Muscle ◽

Suprascapular Nerve ◽

Shoulder Function ◽

Axillary Nerve ◽

Infraspinatus Muscle ◽

Function Recovery ◽

Grade 3

Object The aim of this retrospective study was to evaluate the restoration of shoulder function by means of supra-scapular nerve neurotization in adult patients with proximal C-5 and C-6 lesions due to a severe brachial plexus traction injury (BPTI). The primary goal of brachial plexus reconstructive surgery was to restore the biceps muscle function and, secondarily, to reanimate shoulder function. Methods Suprascapular nerve neurotization was performed by grafting the C-5 nerve in 24 patients and by accessory or hypoglossal nerve transfer in 29 patients. Additional neurotization involving the axillary nerve could be performed in 18 patients. Postoperative needle electromyography studies of the supraspinatus, infraspinatus, and deltoid muscles showed signs of reinnervation in most patients; however, active glenohumeral shoulder function recovery was poor. In nine (17%) of 53 patients supraspinatus muscle strength was Medical Research Council (MRC) Grade 3 or 4 and in four (8%) infraspinatus muscle power was Grade 3 or 4. In 18 patients in whom deltoid muscle reinnervation was attempted, MRC Grade 3 or 4 function was demonstrated in two (11%). In the overall group, eight patients (15%) exhibited glenohumeral abduction with a mean of 44 ± 17° (standard deviation [SD]) (median 45°) and four patients (8%) exhibited glenohumeral exorotation with a mean of 48 ± 24° (SD) (median 53°). In only three patients (6%) were both functions regained. Conclusions The reanimation of shoulder function in patients with proximal C-5 and C-6 BPTIs following supra-scapular nerve neurotization is disappointingly low.

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