Improved range of motion in three cases following axillary nerve hydrorelease after reverse shoulder arthroplasty: a...

Quadrilateral space syndrome following a reverse total shoulder arthroplasty may be underdiagnosed owing to the difficulty in recognizing its symptoms. However, quadrilateral space syndrome following a reverse total shoulder arthroplasty may cause postoperative limitation of range of motion and affect clinical outcomes. The study aimed to report three cases of quadrilateral space syndrome after a reverse total shoulder arthroplasty, resulting in limited range of motion, in which hydrorelease of the axillary nerve improved the limited range of motion.

This study presents three cases of limited anterior elevation and abduction (<100 degrees) at 3 months following a reverse total shoulder arthroplasty, in which hydrorelease of the axillary nerve for quadrilateral space syndrome led to rapid improvement, sustained at 1 year postoperatively. Furthermore, the American Shoulder and Elbow Surgeons score, Constant score, and Subjective Shoulder Value improved in all three cases. All three cases involved small female patients, each <150 cm in height. Although upper limb lengthening was modest (14-19 mm), the patients' small body size may have led to proportionally greater traction on the axillary nerve, potentially contributing to quadrilateral space syndrome.

Hydrorelease of the axillary nerve may be effective in alleviating early postoperative limitations in anterior elevation and abduction in patients with quadrilateral space syndrome following a reverse total shoulder arthroplasty.