Keizo Morisawa

Bilateral suprascapular nerve entrapment syndrome associated with rotator cuff tear

A 51-year-old man had bilateral posterior aching of the shoulder and atrophy of the supraspinatus and infraspinatus muscles caused by suprascapular nerve entrapment syndrome associated with rotator cuff tears. Electromyography and a nerve conduction study revealed denervation potentials and delayed nerve conduction velocities. Cutting of the superior transverse scapular ligament and external neurolysis of the nerve on both sides followed by anterior acromioplasty brought diminished pain, weakness, and atrophy of the supraspinatus and infraspinatus muscles. Although suprascapular nerve entrapment syndrome is an infrequently recognized cause of disability in the shoulder region, awareness of its clinical presentation (referred shoulder pain with associated weakness and atrophy of the supraspinatus and infraspinatus muscles) can lead to a correct early diagnosis. So far a bilateral suprascapular nerve entrapment syndrome has rarely been described.1,3,5 To

Functional outcome of anterior transposition of the vascularized ulnar nerve for cubital tunnel syndrome

Anterior transposition of the ulnar nerve is a widely used treatment for cubital tunnel syndrome, but neurolysis performed at the time of surgery may impair the blood supply to the ulnar nerve. This study compared the results of intramuscular anterior transposition of the ulnar nerve with or without preserving the extrinsic vessels of the ulnar nerve in 35 patients. The postoperative nerve conduction velocity and the clinical results were better in the group in which the extrinsic vessels were presented.

Apophysitis of the acromion.

We treated three patients with apophysitis of the acromion. These patients were two male athletes 12 and 14 years of age, respectively, and one female athlete 13 years of age. They reported pain at the top of the shoulder during and after shoulder movement while playing sports but had no rest pain or disturbance of daily activities. Physical examination demonstrated marked local tenderness at the acromion and slight warmth. X-ray films showed sclerosis and irregularity of the secondary ossification center of the acromion. Bone scintigraphy carried out on one patient demonstrated increased uptake in that region. Conservative treatment was used for these patients. Recovery was gradual but satisfactory.