Acta Orthop. Belg.
Entrapment neuropathy of the suprascapular nerve(SNE),although a recognised clinical entity,is a rela-tively rare cause of shoulder pain and subjectiveweakness in the athlete involved in overhead sportslike volleyball and badminton.This study deals with the presentation and manage-ment of four unusual cases of suprascapular nerveentrapment in volleyball players. Four male volley-ball players presented to our department withintractable shoulder pain and subjective sensation of shoulder weakness. They all had visible wasting of both supraspinatus and infraspinatus muscles,together with weakness of abduction and externalrotation of the arm. They all responded temporarilyto a diagnostic injection of local anaesthetic. MRimaging was useful in diagnosing space occupyinglesions in three cases and the presence of a hyper-trophic suprascapular ligament in one case.Due to failure of non- operative treatment,whichincluded activity modification,rest,analgesics andrehabilitation programme over 6 months,surgerywas then required to decompress the suprascapularnerve.All patients were symptom free at 6 months postop-eratively and after an intensive rehabilitation pro-gramme,they were able to return to their normallevel of activity including sport.
The suprascapular nerve is a mixed peripheralnerve arising from the upper trunk of the brachialplexus,which is formed by the roots of C
nerves. It passes laterally deep to the trapezius andomohyoid muscles and then traverses the supras-capular notch,innervating the supraspinatus mus-cle and gives off variable articular and sensorybranches before passing around the lateral borderof the spine of the scapula through the spinoglenoidnotch to innervate the infraspinatus muscle.By far the most common cause of suprascapularneuropathy is trauma,with fractures of the scapulaand proximal humerus and shoulder dislocationaccounting for the majority of cases
.In addition,an overuse type mechanism of injury to the nerve atthe suprascapular or spinoglenoid notches has beenreported
. Space occupying lesions such astumours,ganglia and haematomas can cause nerveimpingement,though some cases of nerve dysfunc-tion remain idiopathic.
PATIENTS AND METHODS
Four patients between the ages of 22 to 28 presentedto our department with intractable shoulder pain and asubjective sensation of shoulder weakness. All weremale volleyball players.
Acta Orthopædica Belgica, Vol.71 - 3 - 2005
Suprascapular neuropathy in volleyball players
From the Royal Centre for Defence Medicine,Birmingham,UK &Good Hope Hospitals NHS Trust,Birmingham,UK
Asterios Dramis MRCS,Senior House Officer.
Surg Cdr Ashvin Pimpalnerkar,RN,MCh Orth,FRCSOrth,Consultant Orthopaedic & Sports Surgeon.Correspondence:Asterios Dramis,38 Pakenham Road,Edgbaston,Birmingham,B15 2NE,United Kingdom.E-mail :email@example.com.©2005,Acta Orthopædica Belgica.