Axillary Nerve Decompression for Neurogenic Quandrangular Space Syndrome in a Volleyball Player: 2-Dimensional...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Neuroscience

Background:

• Quadrangular space syndrome (QSS) is a rare condition causing axillary nerve compression.
• It leads to shoulder pain, weakness, and deltoid atrophy, often seen in overhead athletes.
• Neurogenic QSS results from nerve entrapment by fibrotic bands, cysts, trauma, or lesions.

Purpose of the Study:

• To evaluate the effectiveness of axillary nerve decompression for neurogenic QSS in a competitive athlete.
• To assess functional recovery and return to sports after surgical intervention.

Main Methods:

• A 21-year-old female volleyball player with a 5-year history of progressive shoulder pain and weakness underwent surgical treatment.
• Electromyography and MRI confirmed axillary nerve compression and deltoid denervation.
• A posterior surgical approach was used for microsurgical axillary nerve decompression, releasing a fibrotic band.

Main Results:

• The patient experienced significant postoperative improvement in deltoid muscle mass and strength.
• Full recovery and a return to sports were achieved by 6 months postoperatively.
• Durable symptom relief was maintained at 2 years postoperatively.

Conclusions:

• Axillary nerve decompression is an effective treatment for neurogenic QSS, particularly when conservative measures fail.
• The procedure successfully restored shoulder function and enabled a complete return to athletic activity.
• Outcomes align with existing literature, supporting surgical intervention for refractory QSS.