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Quadrilateral space syndrome: diagnosis and operative decompression technique
T J Francel1, A L Dellon, J N Campbell
1Division of Plastic Surgery, Johns Hopkins School of Medicine, Baltimore, Md.
Plastic and Reconstructive Surgery
|May 1, 1991
Summary
Quadrilateral space syndrome diagnosis involves specific shoulder tenderness, arm paresthesia, and deltoid weakness. A novel surgical approach offers cosmetic benefits and aids rehabilitation without arteriography.
Area of Science:
- Orthopedic Surgery
- Neurology
- Sports Medicine
Background:
- Quadrilateral space syndrome (QSS) is a rare condition causing shoulder and arm pain.
- It results from compression of the axillary nerve and posterior circumflex humeral artery within the quadrilateral space.
- Diagnosis can be challenging, often requiring a combination of clinical findings and imaging.
Purpose of the Study:
- To describe the diagnostic criteria and a novel surgical technique for QSS.
- To evaluate the efficacy of the described operative approach.
- To determine the necessity of arteriography in diagnosing axillary nerve entrapment within the quadrilateral space.
Main Methods:
- Retrospective review of five patients diagnosed with QSS.
- Clinical examination including palpation of the quadrilateral space, assessment of sensation, and evaluation of deltoid strength and shoulder abduction.
- Surgical intervention using a cosmetically acceptable incision without detaching the deltoid origin.
Main Results:
- All five patients presented with characteristic tenderness, paresthesia, and deltoid weakness.
- A history of trauma was noted in all cases.
- The described surgical technique was effective, minimizing bleeding and facilitating rehabilitation.
Conclusions:
- The clinical findings presented are reliable for diagnosing QSS.
- A minimally invasive surgical technique can successfully treat QSS.
- Arteriography is not essential for diagnosing axillary nerve entrapment in QSS.