腋窩神経障害が主病変と考えられた投球障害肩の治療成績

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Background: Axillary nerve lesion is supposed to be a possible factor in causing throwing shoulder injury. The purpose of this paper was to investigate a clinical result of conservative and surgical treatment for symptomatic axillary nerve lesion in overhead athletes. Methods: We studied 32 overhead athletes with this lesion. There were 26 males and 6 females with a mean age of 18.9 years old (range 10 to 28). The diagnosis of an axillary nerve lesion was made when the patient had hypesthesia in the distribution of axillary nerve, tenderness of the quadrilateral space (QLS) or the axillary fossa, and positive block test on the tender point. The range of motion of the shoulder was measured bilaterally on the first visit. All patients underwent the following conservative treatment, suspension of sports activity, whole body reconditioning, throwing form correction, stretching of the muscles surrounding the QLS, and tender point block. We performed an axillary nerve release on 4 patients resistant to a conservative treatment for a minimum of 3 months. Results: All patients had posterior shoulder tightness on the first visit. After our treatment all patients could return to sports activity with the complete recovery rate of 87.5%. JOA shoulder sports score improved significantly from 55 points on the first visit to 89 points on the final visit. Conclusion: Axillary nerve lesion is not so rare in overhead athletes and should not be missed. For most patients, conservative treatment was sufficient, however, surgical decompression of the axillary nerve was necessary for refractory patients.

腋窩神経障害が主病変と考えられた投球障害肩の治療成績

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