Isolated and combined lesions of the axillary nerve: A review of 146 cases

• Published in: Journal of bone and joint surgery. British volume Vol. 81; no. 2; pp. 212 - 217
• Main Authors: BONNARD, C, ANASTAKIS, D. J, VAN MELLE, G, NARAKAS, A. O
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.03.1999; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Adolescent; Adult; Aged; Aging - physiology; Axilla; Biological and medical sciences; Child; Cranial nerves. Peripheral nerves. Autonomic nervous system; Female; Humans; Male; Medical sciences; Middle Aged; Motor Activity; Muscle, Skeletal - injuries; Muscle, Skeletal - innervation; Muscle, Skeletal - physiopathology; Neurosurgery; Peripheral Nerves - transplantation; Rotator Cuff - innervation; Rotator Cuff - physiopathology; Rotator Cuff Injuries; Shoulder; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Human; Nervous system diseases; Pathophysiology; Innervation; Diseases of the osteoarticular system; Deltoid muscle; Trauma; Association; Functional recovery; Treatment; Surgery; Shoulder; Circumflex nerve; Peripheral nerve disease; Lesion; Technique
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.81B2.0810212

We have assessed the final strength of the deltoid in 121 patients who had repair of isolated or combined lesions of the axillary (circumflex) nerve and were available for statistical analysis. Successful or useful results were achieved in 85% after grafting of isolated lesions. The strength was statistically better when patients had grafting of the axillary nerve within 5.3 months from the time of injury. The dramatic decrease in the rate of success seen with longer delays suggests that surgery should be undertaken within three months of injury. A statistically significant downward trend of the rate of success was noted with increasing age. The force and level of injury to the shoulder play an important role in the type, combination and level of nerve damage and the incidence of associated rotator-cuff, vascular and other injuries to the upper limb. Management of isolated and combined lesions of the axillary nerve after injury to the shoulder needs to be thorough and systematic.