injury of the suprascapular nerve

INTRODUCTION: Baseplate screws have been suggested as a possible cause of suprascapular neuropathy after reverse total shoulder arthroplasty (RTSA). This study aims to investigate the association between screw penetration out of the vault, electromyographic study and the clinical outcomes. METHODS: 31 patients who underwent RTSA for cuff tear arthropathy were prospectively enrolled. They were followed up for a minimum of 24 months. All underwent computed tomography 6 months postoperatively in order to determine the extraosseous position of the screws (perforation of the second bone cortex and protrusion into the supra or infraspinatus fossa)...

Distal nerve transfers to restore elbow flexion have become standard of care in brachial plexus reconstruction. The purpose of this report is to draw attention to intractable co-contraction as a rare but significant adverse event of distal nerve transfers. Here we report of treatment of a disabling co-contraction of the brachialis muscle and wrist/finger flexors after median to brachialis fascicular transfer in a 61-year-old male patient. The primary injury was an postganglionic lesion of roots C5/C6 and a preganglionic injury of C7/C8 with intact root Th1 after a motor bicycle accident...

BACKGROUND: The optimal method for postoperative analgesia after arthroscopic rotator cuff repair (ARCR) is still unclear. PURPOSE: To compare the efficacy of postoperative analgesic methods after ARCR through network meta-analysis of randomized controlled trials and prospective controlled trials. STUDY DESIGN: Systematic review; Level of evidence, 2. METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, Embase, and Web of Science from inception until April 12, 2022, for randomized controlled trials and prospective controlled trials evaluating neuraxial analgesia, peripheral nerve block, periarticular local anesthetic infiltration, intravenous patient-controlled analgesia, oral analgesia, or any combination of these methods for pain management after ARCR...

BACKGROUND: Massive rotator cuff tears (RCTs) are complicated by muscle atrophy, fibrosis, and intramuscular fatty degeneration, which are associated with postoperative tendon-to-bone healing failure and poor clinical outcomes. We evaluated muscle and enthesis changes in large tears with or without suprascapular nerve (SN) injury in a rat model. METHODS: Sixty-two adult Sprague-Dawley rats were divided into SN injury (+) and SN injury (-) groups (n=31 each), comprising tendon (supraspinatus [SSP]/infraspinatus [ISP]) and nerve resection and tendon resection only cases, respectively...

BACKGROUND: Paralysis after spinal cord injury involves damage to pathways that connect neurons in the brain to peripheral nerves in the limbs. Re-establishing this communication using neural interfaces has the potential to bridge the gap and restore upper extremity function to people with high tetraplegia. OBJECTIVE: We report a novel approach for restoring upper extremity function using selective peripheral nerve stimulation controlled by intracortical microelectrode recordings from sensorimotor networks, along with restoration of tactile sensation of the hand using intracortical microstimulation...

OBJECTIVES: Peripheral nerve surgeons disagree on the optimal timing and treatment of brachial plexus injuries (BPI). This study aims to survey peripheral nerve surgeons on their management of BPI, including disagreement. METHODS: Surgeons responded to a case-based survey involving traumatic and birth injuries leading to BPI involving the upper and lower trunks, and pre- and post-ganglionic injuries. RESULTS: Out of 255 invited surgeons, 154 participated, with specialties of Neurosurgery (33...

BACKGROUND: Anterior glenohumeral dislocation is a common injury seen in the emergency department (ED) that sometimes requires procedural sedation for manual reduction. When compared with procedural sedation for dislocation reductions, peripheral nerve blocks provide similar patient satisfaction scores but have shorter ED length of stays. In this case report, we describe the first addition of an ultrasound-guided axillary nerve block to a suprascapular nerve block for reduction of an anterior shoulder dislocation in the ED...

BACKGROUND: Although the classic open Latarjet has a low recurrence rate in unstable shoulders, this advantage may be offset by the higher number of complications. We aimed to report the safety-driven nuanced steps and the resulting short-term complications of the Latarjet-Walch technique. METHODS: Between 2016 and 2022, 150 patients who underwent the Latarjet procedure following the key safety-driven technical steps were retrospectively evaluated for intraoperative and short-term (3 months) complications...

BACKGROUND: Suprascapular nerve (SSN) entrapment in volleyball players leads to infraspinatus (ISP) muscle atrophy and weakness of abduction and external rotation (ER) of the shoulder. PURPOSE: To assess functional outcome after arthroscopic extended decompression of SSN in the spinoglenoid notch and suprascapular notch in a group of volleyball athletes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Volleyballers who underwent arthroscopic SSN decompression were analyzed retrospectively...

BACKGROUND: Reparation of C5 by proximal selective ipsilateral C7 transfer has been reported for the treatment of neurogenic shoulder abduction limitation as an alternative to the reparation of the suprascapular nerve (SSN) and the axillary nerve (AXN) by distal nerve transfers. However, there is a lack of evidence to support either strategy leading to better outcomes based on long-term follow-up. OBJECTIVE: The purpose of the study was to investigate the safety and long-term outcomes of the posterior division of ipsilateral C7 (PDIC7) transfer to C5 in treating neurogenic shoulder abduction limitation...

This case report aims to encourage teams to readjust the operating table during prolonged robotic cases, especially in those patients with a high body mass index. We present the case of a 59-year-old male who developed neuropathic pain involving the suprascapular nerve distribution following a prolonged robotic-assisted radical prostatectomy.

Of the many bizarre complications of administration of the COVID 19 vaccine, adhesive capsulitis is almost unheard-of, although Shoulder Injury following Vaccine Administration (SIRVA), which by definition has symptom onset within 48 hours and is caused by faulty injection technique, has been rarely reported. Nine cases of adhesive capsulitis, five males and four females with a mean age of 48.7 ± 12.7 years, presenting within one month of intramuscular Covishield™ vaccine on the ipsilateral deltoid and fulfilling the standard UK FROST Multicenter Study diagnostic criteria are reported...

OBJECTIVE: Until recently, autologous sensory nerve grafting has remained the gold-standard technique in peripheral nerve reconstruction. However, there are several disadvantages to these grafts, such as donor site morbidity, limited availability, and a qualitative mismatch. Building on this shortage, a new concept, the fascicular shift procedure, was proposed and successfully demonstrated nerve regeneration in a rat nerve injury model. This approach involves harvesting a fascicular group distal to a peripheral nerve injury and shifting it to bridge the defect...

Neonatal brachial plexus palsy describes injury to the brachial plexus in the perinatal period, resulting in motor and sensory deficits of the upper arm. Nerve reconstruction, including graft repair and nerve transfers, can be used to restore function in patients whose injury does not respond to conservative management. Despite the availability of these techniques, 30%-40% of children have lifelong disability, reflecting a 10-fold underutilization of surgery. Here, the authors demonstrate a supraclavicular approach for brachial plexus exploration, as well as a spinal accessory to suprascapular nerve transfer for restoration of shoulder abduction and external rotation...

OBJECTIVES: To investigate the anatomical feasibility of the infraspinatus branch of the suprascapular nerve (IB-SSN) reconstruction by lower subscapular nerve (LSN) transfer. METHODS: The morphological study was performed on 18 adult human cadavers. The length of the distal stump of the IB-SSN, the length of the LSN available for reconstruction and diameter of both stumps were measured. The feasibility study of the LSN to IB-SSN transfer was performed. RESULTS: The mean length of the IB-SSN to the end of its first branch was 40...

OBJECTIVE: This prospective, randomized study aimed to compare anterior suprascapular nerve block versus interscalene block in terms of diaphragm paralysis in arthroscopic shoulder surgery. METHODS: Fifty-two patients undergoing shoulder arthroscopy surgery were prospectively randomly assigned to interscalene block (n=25) or anterior suprascapular nerve block groups (n=27) (each group receiving 5 mL, 0.5% bupivacaine). The ipsilateral diaphrag matic excursion was assessed in all patients using ultrasound imaging before (baseline), 30 minutes, and 24 hours after block completion...

Dual nerve transfer of the spinal accessory nerve to the suprascapular nerve (SAN-SSN) and the radial nerve to the axillary nerve is considered to be the most feasible method of restoration of shoulder abduction in brachial plexus injuries. Supraspinatus muscle plays an important role in the initiation of abduction and its functional restoration is crucial for shoulder movements. There are two possible approaches for the SAN-SSN transfer: the more conventional anterior approach and the posterior approach in the area of scapular spine, which allows more distal neurotization...

Neurogenic thoracic outlet syndrome is a challenging condition to diagnose and treat, often precipitated by the triad of repetitive overhead activity, pectoralis minor contracture, and scapular dyskinesia. The resultant protracted scapular posture creates gradual repetitive traction injury of the suprascapular nerve via tethering at the suprascapular notch and decreases the volume of the brachial plexus cords and axillary vessels in the retropectoralis minor space. A stepwise and exhaustive diagnostic protocol is essential to exclude alternate pathologies and confirm the diagnosis of this dynamic pathologic process...

BACKGROUND: Axillary thoracotomy and muscle flap are muscle- and nerve-sparing methods among the surgical approaches to bronchopleural fistula (BPF). However, in patients who are vulnerable to a nerve compression injury, nerve injury may occur. In this report, we present a unique case in which the brachial plexus (division level), suprascapular, and long thoracic nerve injury occurred after BPF closure surgery in a patient with ankylosing spondylitis and concomitant multiple joint contractures...

Introduction : Superior screw insertion in reverse shoulder arthroplasty (RSA) carries the potential risk of suprascapular injury. The purpose of this study was to evaluate how the baseplate position affects the superior screw position and length in RSA. Methods : Three-dimensional (3D) computer simulation models of RSA were established using computed tomography data of baseplates with superior and inferior screws and 3D scapular models from 10 fresh cadavers. Superior screw position, the distance from the superior screw hole to the suprascapular notch, and the screw lengths were measured and compared among various baseplate positions with two inferior tilts (0 and 10 degrees) and three rotational patterns (11-5, 12-6, and 1-7 o'clock in the right shoulder)...