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首页> 外文期刊>Journal of Medical Case Reports >An unusual case of suprascapular nerve neuropathy: a case report
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An unusual case of suprascapular nerve neuropathy: a case report

机译：肩cap上神经病变的一例：病例报告

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Introduction Suprascapular nerve neuropathy constitutes an unusual cause of shoulder weakness, with the most common etiology being nerve compression from a ganglion cyst at the suprascapular or spinoglenoid notch. We present a puzzling case of a man with suprascapular nerve neuropathy that may have been associated with an appendectomy. The case was attributed to nerve injury as the most likely cause that may have occurred during improper post-operative patient mobilization. Case presentation A 23-year-old Caucasian man presented to an orthopedic surgeon with a history of left shoulder weakness of several weeks' duration. The patient complained of pain and inability to lift minimal weight, such as a glass of water, following an appendectomy. His orthopedic clinical examination revealed obvious atrophy of the supraspinatus and infraspinatus muscles and 2 of 5 muscle strength scores on flexion resistance and external rotation resistance. Magnetic resonance imaging showed diffuse high signal intensity within the supraspinatus and infraspinatus muscles and early signs of minimal fatty infiltration consistent with denervation changes. No compression of the suprascapular nerve in the suprascapular or spinoglenoid notch was noted. Electromyographic studies showed active denervation effects in the supraspinatus muscle and more prominent in the left infraspinatus muscle. The findings were compatible with damage to the suprascapular nerve, especially the part supplying the infraspinatus muscle. On the basis of the patient's history, clinical examination, and imaging studies, the diagnosis was suspected to be associated with a possible traction injury of the suprascapular nerve that could have occurred during the patient's transfer from the operating table following an appendectomy. Conclusion Our case report may provide important insight into patient transfer techniques used by hospital personnel, may elucidate the clinical significance of careful movement of patients following general anesthesia, and may have important implications for patient safety techniques, including those outlined in the World Health Organization Surgical Safety Checklist program.
机译：引言肩cap上神经病变是肩关节无力的一个不寻常原因，最常见的病因是肩cap上或旋舌状肌切迹的神经节囊肿压迫神经。我们提出了一个令人困惑的病例，该病例患有肩cap上神经神经病变，可能与阑尾切除术有关。该病例归因于神经损伤，这是术后患者动员不当的最可能原因。病例介绍一名23岁的白人男子向一位整形外科医生介绍了一个有几周病程的左肩无力病史。该患者抱怨阑尾切除术后疼痛和无法举起最小的重量，例如一杯水。他的整形外科临床检查显示，上睑上肌和脊柱下肌明显萎缩，屈曲阻力和外旋阻力的5个肌肉强度得分中有2个得分。磁共振成像显示在棘上肌和棘下肌内弥散的高信号强度，以及与神经支配变化一致的最小脂肪浸润的早期迹象。在肩cap上或旋舌状肌切迹中未见肩cap上神经受压。肌电图研究显示，在脊椎上肌有积极的去神经作用，而在左鼻下肌中则更为明显。这些发现与肩cap上神经的损伤相符，特别是对供应腓骨下肌的部分。根据患者的病史，临床检查和影像学检查，怀疑该诊断与阑尾切除术后患者从手术台转移时可能发生的肩cap上神经牵拉伤相关。结论我们的病例报告可能会为医院工作人员使用的患者转移技术提供重要见解，可能阐明全麻后患者谨慎运动的临床意义，并且可能会对患者安全技术产生重要影响，包括世界卫生组织外科手术中概述的技术。安全清单程序。

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