Quadrilateral space syndrome

J Hand Surg Am. 1983 Jan;8(1):65-9. doi: 10.1016/s0363-5023(83)80056-2.


This uncommon syndrome is caused by compression of the posterior humeral circumflex artery and axillary nerve or one of its major branches in the quadrilateral space. Forward flexion and/or abduction and external rotation of the humerus aggravate the symptoms. Discrete point tenderness is always found posteriorly in the quadrilateral space. Patients with appropriate history and physical findings should have a subclavian arteriogram done by the Seldinger technique. A positive arteriogram reveals occlusion of the posterior humeral circumflex artery with the arm in abduction and external rotation. Patients with sufficient symptoms not responding to conservative treatment and having a positive subclavian arteriogram and local tenderness over the quadrilateral space should be considered for surgical decompression. A posterior approach is recommended. Of the 18 patients operated on, eight have had dramatic and complete relief, eight have been improved, and two have shown no improvement.

MeSH terms

  • Adult
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / surgery
  • Axilla
  • Humans
  • Nerve Compression Syndromes / diagnostic imaging
  • Nerve Compression Syndromes / surgery*
  • Radiography
  • Subclavian Artery / diagnostic imaging