Axillary nerve injury associated with glenohumeral dislocation

Avis, Duncan; Power, Dominic

doi:10.1302/2058-5241.3.170003

Cited by 30 publications

(22 citation statements)

References 41 publications

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“…Dislocations of the glenohumeral joint are common, with a reported incidence of 40.4 per 100,000 male person years and 15.5 per 100,000 female person years (Shah et al, 2017). The incidence is bimodal, affecting young males and older females (Avis and Power, 2018;Cutts et al, 2009;Krøner et al, 1989). A higher proportion of older females are reported to suffer dislocations after falling at home, whereas males are more often involved in high-energy mechanisms, such as road traffic accidents or sports injuries (Avis and Power, 2018;Cutts et al, 2009;Krøner et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

“…The incidence is bimodal, affecting young males and older females (Avis and Power, 2018;Cutts et al, 2009;Krøner et al, 1989). A higher proportion of older females are reported to suffer dislocations after falling at home, whereas males are more often involved in high-energy mechanisms, such as road traffic accidents or sports injuries (Avis and Power, 2018;Cutts et al, 2009;Krøner et al, 1989). However, even for low-energy injuries, a glenohumeral dislocation can substantially traumatize surrounding structures, including the brachial plexus (Gutkowska et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Functional deficits as a result of brachial plexus injury in anterior shoulder dislocation

Jordan

Wade

McCauley

et al. 2021

J Hand Surg Eur Vol

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The incidence of brachial plexus injuries in anterior shoulder dislocation remains relatively uncommon. A retrospective study was conducted to observe the natural neurological recovery of patients following these injuries over a 2-year period. Muscle power according to the Medical Research Council scale and sensation were measured from presentation to discharge. In 28 patients, the power grade of proximal muscles supplied by nine injured nerves failed to improve over a median follow-up of 5 months. There was no statistically significant improvement in sensation over a median follow-up of 6 months. Poorer recovery in muscle power score was related to advancing age, whereby every decade increased the risk by approximately 30%. Anterior shoulder dislocation with a plexus injury carries a risk of permanent nerve injury. Patients should be referred for specialist nerve assessment leading to rehabilitation and timely early nerve reconstruction, if indicated. Level of evidence: IV

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional deficits as a result of brachial plexus injury in anterior shoulder dislocation

Jordan

Wade

McCauley

et al. 2021

J Hand Surg Eur Vol

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“…The axillary nerve branch to the Tm may be injured during both open and arthroscopic procedures, as it arises from the posterior branch of the axillary nerve adjacent to the inferior aspect of the capsule at the level of the glenoid rim 11 . Differences in the bifurcation pattern or innervation between the anterior and posterior branches can explain isolated palsy of the deltoid or the Tm with or without sensory loss in the axillary nerve distribution 11‐14 . We observed some variation in axillary nerve branching in the quadrangular space.…”

Section: Discussionmentioning

confidence: 74%

Anatomy of the nerves to the teres minor and the long head of the triceps brachii for electromyography

et al. 2020

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Background We investigated the branching pattern and topographic anatomy of the nerves to the teres minor (Tm) and the long head of the triceps brachii (LHT) in relation to reference lines extending between surface landmarks, to identify the innervation patterns of, and the optimal needle placement points within, the Tm and the LHT. Methods The anatomical courses of the nerves to the Tm and the LHT were investigated in 37 upper limbs of fresh‐frozen cadavers. Distances from the acromion to nerve penetration points, and crossing points of reference lines with the Tm and LHT were measured in 27 cadaveric upper limbs. Results The Tm was innervated by the axillary nerve in all specimens in three patterns, and the LHT was innervated exclusively by the radial nerve. Our dissection and measurements indicate that the midpoint of the reference line from the acromion to the inferior angle of the scapula is the optimal needle insertion point for the Tm. The target point for the LHT appears to be the one‐third point of the reference line from the acromion to the medial epicondyle, or the two‐thirds point of the reference line from the acromion to the axillary fold. Conclusions We investigated the branching pattern of the nerves to the Tm and the LHT and propose optimal needle placement points for electromyography of the Tm and LHT.

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“…These injuries may benefit from early exploration and neurolysis, and if on examination at 9 months there is no progress in recovery then rehabilitation is unlikely and nerve transfer may be a good option. 27…”

Section: Discussionmentioning

confidence: 99%

Isolated Radial Nerve Palsy as a Complication After Anterior Dislocation of the Glenohumeral Joint: A Case Report and Clinical Review

Kastanis

Kapsetakis

Velivasakis

et al. 2019

Journal of Investigative Medicine High Impact Case Reports

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Shoulder dislocation is the most common feature in emergencies, while the anterior dislocation of the glenohumeral joint is the most frequent and requires reduction. Accompanied nerve injury is common with an incidence of 21%, while radial nerve palsy is very rare. We describe the case of a 56-year-old man who presented with an anterior dislocation of the left shoulder due to a fall on an outstretched hand with wrist drop 8 hours after injury. Neurological examination revealed loss of sensation along the radial border of the forearm. Closed reduction with Kocher procedure was performed. Magnetic resonance image demonstrated a rotator cuff tear, and 3 weeks after the injury electromyography showed complete radial nerve palsy. A physiotherapy program was applied to the wrist and fingers with the goal of maintaining a full passive range of motion in all joints affected while shoulder rehabilitation started 6 weeks after his fall. Isolated radial nerve palsy associated with an anterior dislocation of the shoulder is very rare but not impossible to occur. Correct diagnosis of the nerve injury associated with the anterior dislocation is very important because it has serious implications on the management and activity morbidity.

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Axillary nerve injury associated with glenohumeral dislocation

Cited by 30 publications

References 41 publications

Functional deficits as a result of brachial plexus injury in anterior shoulder dislocation

Functional deficits as a result of brachial plexus injury in anterior shoulder dislocation

Anatomy of the nerves to the teres minor and the long head of the triceps brachii for electromyography

Isolated Radial Nerve Palsy as a Complication After Anterior Dislocation of the Glenohumeral Joint: A Case Report and Clinical Review

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