Neurotization of isolated axillary nerve palsy in a teenage patient

Determination of safe sites of intramuscular arm injections and its relevance to the community

“…A mild transient reversible paresthesia or compression may occur which will soon subside and patients can be properly reassured regarding the same. [ 10 11 12 13 ] Moreover, the type of injection needle chosen in this study and the angle of its insertion conform to those of the standard norms already established in previous studies. [ 11 12 13 ]…”

“…[ 10 11 12 13 ] Moreover, the type of injection needle chosen in this study and the angle of its insertion conform to those of the standard norms already established in previous studies. [ 11 12 13 ]…”

“…Hence, the ultimate goal of this study was to establish a series of safe points considering the variant course of the anterior branch of the axillary nerve in this subset of the population, and so, the points I, II, and III (as depicted in Figure 1 ) were found to be safe in a series after analyzing the results. Many studies agree to the bisector point method as the safest[ 11 12 13 14 ] but population-based studies on the same are still lacking. Textbooks to date have not still included the other safe points apart from the usual one,[ 1 2 ] hence, this study would also serve as an eye-opener to other possible inclusion of safe points.…”

“…[ 14 15 16 ] However, there has been a slight discrepancy between the findings established by sonographic studies and those of the cadavers, possibly because these studies have been done in different populations. [ 10 11 12 13 14 15 ] The present study, however, does not use ultrasound findings of the posterior circumflex humeral artery as a guide to course out the axillary nerve because the prime motive of the workers in this study is to establish an affordable cum accessible protocol of a series of safe injection points based on the results of this study for health care workers not only working in tertiary care hospitals with access to ultrasound but also for those workers who deal with vaccinations or therapeutic injections in rural health centers or community health centers where ultrasound is either not accessible or not affordable. Moreover, it is practically not possible for every doctor or nurse or lab personnel working in rural areas or community health centers in this region to use ultrasound every time to localize the branches of axillary nerve across the deltoid before administering injections owing to the large crowds of patients that visit outpatient departments of hospitals every day.…”