棘下筋萎縮に対して鏡視下神経剥離術を行い復帰したバレーボール選手の1例  [in Japanese] Arthroscopic Decompression of Suprascapular Nerve for Infraspinatus Muscle Atrophy in Volleyball Player : A Case Report  [in Japanese]

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Abstract

Over head activityのスポーツ選手において棘下筋萎縮を生じることがある.保存的治療で一時的に改善したがプレー復帰後再発し,関節鏡視下手術によりスポーツ復帰した症例を経験したので報告する.15歳男性.高校バレーボール選手.スパイクを打つ際の右肩痛と右肩後面の脱力感,易疲労感を主訴に受診した.初診時,棘下筋萎縮及び肩甲骨下制位を認めた.MRI上ガングリオン等占拠性病変は認めなかったが著明な棘下筋萎縮を認めたため,スパイク動作による肩甲上神経の絞扼と判断した.右側でのスパイク禁止および肩甲骨下制筋群のストレッチを施行した.3カ月後,右肩痛は消失し棘下筋萎縮が改善したため右側でのスパイクを許可した.復帰後4カ月で症状が再発し,MRIで棘下筋萎縮の悪化を認めたため手術を施行した.鏡視下に上肩甲横靱帯を切離し,肩甲上神経を剥離した.術後1カ月で完全復帰し,術後5カ月のMRIで棘下筋萎縮は改善し症状なく元の競技レベルに復帰している.

Infraspinatus muscle atrophy is sometimes seen in volleyball players. We report a case of infraspinatus muscle atrophy which was treated by arthroscopic suprascapular nerve decompression. The patient was a 16-year-old male volleyball player complaining of right shoulder pain and fatigue. Infraspinatus muscle atrophy and scaplar descent were observed. In MRI, there were no space occupying the lesion around the suprascapular nerve but obvious infraspinatus muscle atrophy. We diagnosed suprascapular nerve entrapment caused by spike motion. Right hand spike was prohibited and stretching of parascapula muscles was instructed in conservative treatment. Right shoulder pain and muscle atrophy improved after three months of conservative treatment, so we allowed right hand spike. Four months after retuning to play volleyball, the patient had the same symptoms as before the conservative treatment. Also infraspinatus muscle atrophy became worse in MRI. Therefore we performed arthroscopic suprascapular nerve decompression. One month after surgery, the patient returned to play volleyball. Five months after surgery, he could play volleyball like before and infraspinatus muscle atrophy recovered in MRI.

Journal

Orthopedics & Traumatology  

Orthopedics & Traumatology 60(4), 780-784, 2011-09-25 

West-Japanese Society of Orthopedics & Traumatology

References:  10

Codes

  • NII Article ID (NAID) :
    10029660891
  • NII NACSIS-CAT ID (NCID) :
    AN00126582
  • Text Lang :
    JPN
  • Article Type :
    NOT
  • ISSN :
    00371033
  • Databases :
    CJP  J-STAGE