Injury of axillary nerve
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Injury of axillary nerve | |
---|---|
Synonyms | N/A |
Pronounce | N/A |
Specialty | N/A |
Symptoms | Deltoid muscle weakness, teres minor weakness, sensory loss over the regimental badge area |
Complications | Shoulder instability, atrophy of the deltoid muscle |
Onset | Trauma, shoulder dislocation, humeral fracture |
Duration | Varies, can be temporary or permanent |
Types | N/A |
Causes | Blunt trauma, compression, traction injury |
Risks | Contact sports, shoulder surgery, repetitive overhead activities |
Diagnosis | Physical examination, nerve conduction study, electromyography |
Differential diagnosis | Rotator cuff tear, brachial plexus injury, cervical radiculopathy |
Prevention | Protective gear, proper technique in sports, physical therapy |
Treatment | Physical therapy, surgical repair, nerve grafting |
Medication | N/A |
Prognosis | Generally good with treatment, but depends on severity |
Frequency | Relatively uncommon |
Deaths | N/A |
Overview of axillary nerve injury
The axillary nerve is a crucial component of the brachial plexus, responsible for innervating the deltoid muscle and the teres minor muscle, as well as providing sensory input from the skin overlying the deltoid. Injury to the axillary nerve can result in significant functional impairment of the shoulder.
Anatomy
The axillary nerve originates from the posterior cord of the brachial plexus, carrying fibers from the C5 and C6 spinal nerves. It travels through the quadrangular space of the shoulder, accompanied by the posterior circumflex humeral artery.
Branches
The axillary nerve gives off several branches:
- The anterior branch innervates the anterior part of the deltoid muscle.
- The posterior branch innervates the posterior part of the deltoid and the teres minor muscle.
- The superior lateral cutaneous nerve of the arm provides sensory innervation to the skin over the deltoid.
Causes of Injury
Injury to the axillary nerve can occur due to various reasons, including:
- Shoulder dislocation
- Fracture of the surgical neck of the humerus
- Compression from improper use of crutches
- Direct trauma to the shoulder region
Clinical Presentation
Patients with axillary nerve injury may present with:
- Weakness or paralysis of the deltoid muscle, leading to difficulty in abduction of the arm
- Atrophy of the deltoid muscle
- Loss of sensation over the lateral aspect of the shoulder
Diagnosis
Diagnosis of axillary nerve injury is primarily clinical, supported by:
- Physical examination
- Electromyography (EMG) and nerve conduction studies
- Magnetic resonance imaging (MRI) to assess the extent of injury
Management
Management of axillary nerve injury depends on the severity and cause of the injury:
- Conservative treatment includes physical therapy and pain management.
- Surgical intervention may be necessary in cases of severe or persistent injury, such as nerve grafting or nerve transfer.
Prognosis
The prognosis for axillary nerve injury varies. Many patients recover with conservative treatment, but some may experience persistent weakness or sensory deficits.
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Contributors: Prab R. Tumpati, MD