[Compression syndromes of the axillary nerve and the suprascapular nerve].
We report on seven patients with altogether four paralyses of the axillary and six paralyses of the suprascapular nerve without a singular trauma. In one patient, the paralysis of the axillary nerve developed spontaneously over night after a period of habitual dislocations of the shoulder joint. Another patient developed a paralysis of the suprascapular nerve after prolonged wearing of a rucksack. Three of the remaining five patients developed both an axillary and suprascapular paresis without any preceeding trauma or irritation. In two further patients, an isolated suprascapular paralysis developed without trauma. An analysis of the intraoperative findings in these five patients shows in all cases adhesions of the nerve with the surrounding tissues at the site of the suprascapular notch respectively the quadrilateral space. In all three cases of axillary nerve paralysis there was in addition a narrow quadrilateral space. However only in three of five suprascapular nerve lesions there was a narrow suprascapular notch. In the two remaining cases adhesions alone had caused the paralysis and produced a serpentine deformity of the nerve. It is concluded that inflammatory processes cause the paralysis and the adhesions. Compression in the narrow space and fibrous changes are responsible for maintaining the paralysis after the inflammation has subsided. Macroscopically unchanged nerves underwent external neurolysis. With fibrous changes an epineuriotomy and with more pronounced changes an epineuriectomy were performed. The results are discussed.
Millesi-Eberhard
D
D
Klinischen Abteilung für Plastische und Wiederherstellende Chirurgie der Chirurgischen Universitätsklinik Wien.
König
B
B
Millesi
H
H
D000328:Adult; D001365:Axilla / Q000294:innervation*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D010243:Paralysis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D010525:Peripheral Nerves / Q000503:physiopathology / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012540:Scapula / Q000294:innervation*; D000267:Tissue Adhesions