Concomitant Ipsilateral Hourglass-Like Constrictions of Suprascapular and Axillary Nerves: Report of a Rare Case

Hourglass-like constriction (HGC) of the nerve is a rare cause of nerve palsy and has been reported for many nerves. We were unable to find previous reports of concomitant constriction of the suprascapular and axillary nerve in literature. Our patient was a young male with shoulder paralysis of 7-months duration. On exploration we found two HGCs of the suprascapular and axillary nerves. A neurolysis of the suprascapular nerve was carried out. The axillary nerve constriction was deemed to be severe and a nerve transfer using the branch innervating the medial head of the triceps motor was done. Patient recovered excellent shoulder function at 1-year post-surgery. Awareness about this rare occurrence will prevent poor outcome from addressing the constriction at only one site. Nerve surgery should be considered for patients who do not show any improvement in 6 months. Level of Evidence: Level IV (Therapeutic).