Axillary nerve injury associated with sports

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>The aim of this retrospective study was to present and investigate axillary nerve injuries associated with sports.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This study retrospectively reviewed 26 axillary nerve injuries associated with sports between the years 1985 and 2010. Preoperative status of the axillary nerve was evaluated by using the Louisiana State University Health Science Center (LSUHSC) grading system published by the senior authors. Intraoperative nerve action potential recordings were performed to check nerve conduction and assess the possibility of resection. Neurolysis, suture, and nerve grafts were used for the surgical repair of the injured nerves. In 9 patients with partial loss of function and 3 with complete loss, neurolysis based on nerve action potential recordings was the primary treatment. Two patients with complete loss of function were treated with resection and suturing and 12 with resection and nerve grafting. The minimum follow-up period was 16 months (mean 20 months).</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The injuries were associated with the following sports: skiing (12 cases), football (5), rugby (2), baseball (2), ice hockey (2), soccer (1), weightlifting (1), and wrestling (1). Functional recovery was excellent. Neurolysis was performed in 9 cases, resulting in an average functional recovery of LSUHSC Grade 4.2. Recovery with graft repairs averaged LSUHSC Grade 3 or better in 11 of 12 cases</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Surgical repair can restore useful deltoid function in patients with sports-associated axillary nerve injuries, even in cases of severe stretch–contusion injury.</jats:p></jats:sec>

Axillary nerve palsy consequent to a guided manual stretch of the upper extremities: a case report

“…In particular, at this location, the overlying muscle tethers the nerve, making it susceptible to stretch injury. 5 This is the hypothesized mechanism in our patient. It is assumed that the manual overpressure applied with stretching led to excessive abduction and internal rotation of the humerus, thus increasing the distance between the quadrilateral space and the nerve's entry into the deltoid muscle (Fig.…”

“…9 In sports-associated AN injuries, skiing and football are the most frequent foregoing activities reported in the literature. 5 In one case report, AN damage associated with the sport of squash was presented. 10 Axillary neuropathy in young volleyball players, as a result of excessive abduction and external rotation with flexion or extension of the arm, has been discussed as a potential mechanism by which the quadrilateral space is confined where the AN exits alongside the scapula.…”

Spinal nerve composition and innervation of the axillary nerve

“…Isolated axillary nerve damage is rare among the other types of nerve injury of the entire brachial plexus. Separate lesions of the axillary nerve have been reported in athletes, including volleyball, hockey, football players, and others . Axillary nerve injury and prognosis for recovery of the deltoid muscle varies widely .…”

“…Separate lesions of the axillary nerve have been reported in athletes, including volleyball, hockey, football players, and others. [8][9][10] Axillary nerve injury and prognosis for recovery of the deltoid muscle varies widely. 11 Axillary nerve injury should be differentiated damage from the surrounding ligaments or muscle damage.…”

Ultrasonographic measurement of the cross‐sectional area of the axillary nerve

“…[1][2][3][4][5] Injuries incurring in sports such as skiing, football, and weight lifting can cause trauma to the axillary nerve. 6 Because surgical repair is useful for preserving deltoid function after sports-related axillary nerve injury, accurate detection and identification of the location of an axillary nerve injury are important. However, it is not easy to confirm lesions of the axillary nerve using routine imaging because the nerve course is complex and extends through several compartments of the shoulder and axillary area.…”