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Neurovascular injuries to the shoulder
1Department of Orthopaedics, Tulane University School of Medicine, New Orleans, LA.
Summary
Throwing athletes face shoulder neurovascular injuries from repetitive motions. Prompt diagnosis and nonoperative treatment allow most athletes to return to sports with minimal disability.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Vascular Surgery
Background:
- Repetitive throwing motions in athletes place excessive demands on the shoulder.
- Throwing athletes are susceptible to neurovascular injuries in the shoulder.
- Common syndromes include axillary artery occlusion, effort thrombosis, quadrilateral space syndrome, and thoracic outlet syndrome.
Purpose of the Study:
- To review the diagnosis and management of neurovascular compression syndromes in throwing athletes.
- To highlight the importance of early recognition and appropriate treatment for optimal outcomes.
Main Methods:
- Review of common neurovascular compression syndromes affecting throwing athletes.
- Discussion of diagnostic maneuvers such as Adson's test, costoclavicular maneuver, and hyperabduction maneuver.
- Overview of treatment strategies, including nonoperative and operative interventions.
Main Results:
- Diagnosis is often aided by specific physical examination tests.
- Initial treatment is typically nonoperative, potentially including anticoagulation or thrombolytic therapy for vascular occlusion.
- Surgical intervention is reserved for refractory cases.
Conclusions:
- Most throwing athletes can resume athletic activities with minimal disability following appropriate treatment.
- Early diagnosis and management are crucial for successful return to sport.
- Understanding these syndromes is vital for sports medicine professionals and orthopedic surgeons.