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Surgical decompression shows efficacy for treating quadrilateral space syndrome in overhead athletes
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Performing surgical decompression can "predictably" relieve shoulder pain and improve shoulder function in overhead athletes who have quadrilateral space syndrome, according to a small study by surgeons in California.
Timothy R. McAdams, MD, and colleague Michael F. Dillingham, MD, reviewed four cases of quadrilateral space syndrome in four shoulders of four such athletes. The patients averaged 24 years of age; follow-up averaged 24.5 month, according to the study, published in The American Journal of Sports Medicine.
The researchers had hypothesized that "Quadrilateral space syndrome can present as posterior shoulder pain in the overhead athlete, and surgical decompression can relieve symptoms and allow full return to activity," according to the study,
In all cases, surgeons performed surgical decompression of the quadrilateral space.
Intraoperatively, surgeons found that fibrous bands had entrapped the axillary nerve in three shoulders and that the fourth shoulder had a venous dilation.
"All patients returned to full activity without pain or limitation of overhead function 12 weeks after surgery," the authors noted.
"Quadrilateral space syndrome is an uncommon cause of posterior shoulder pain that is easily overlooked and can severely limit overhead function in the athlete. Surgical decompression can predictably relieve pain and improve function in patients who do not respond to nonoperative regimens," the authors wrote.
For more information:
- McAdams TR, Dillingham MF. Surgical decompression of the quadrilateral space in overhead athletes. Am J Sports Med. 2008;36:528-532.