手术治疗四边孔综合征的临床观察

Clinical observation of surgical treatment of quadrilateral foramen syndrome

目的了解四边孔的临床解剖,探讨四边孔综合征的临床表现和手术治疗效果。方法对16例四边孔综合征患者的病因、症状、体征及处理方法进行总结、分析,所有患者采用后侧入路手术方法。结果所有患者术后2周复查,伤口均Ⅰ/甲级愈合,肩关节外展约90°,肩部痛点VAS评分为4~6分。术后2个月,随访患者的肩关节主动活动正常,肩部痛点VAS评分<3分,三角肌均无萎缩。结论四边孔综合征临床主要表现是腋神经支配的肩臂外侧的感觉障碍和三角肌功能受限,此病诊断一旦明确,手术治疗可以作为临床选择。

Objective To understand the clinical anatomy of quadrilateral foramen,and explore the clinical manifestations and surgical treatment of quadrilateral foramen syndrome.Methods The etiology,symptoms,signs and treatment methods of 16 patients with quadrilateral foramen syndrome were summarized and analyzed.All patients were given posterior approach surgery.Results All patients had gradeⅠ/A wound healing,about 90°shoulder abduction and 4-6 points of the VAS score of shoulder pain points in reexamining of 2 weeks after operation.On 2 months after operation,the active activity of the shoulder joint of follow-up patients were normal,and the VAS score of shoulder pain point was less than 3 points,without atrophy in trigonometries.Conclusion The main clinical manifestations of quadrilateral foramen syndrome are sensory disturbance of lateral shoulder arm innervated by axillary nerve and deltoid muscle function limitation.Once the diagnosis of this disease is clear,surgical treatment can be a clinical option.