Prevalence of associated injuries after anterior shoulder dislocation: a prospective study

Atef, Ashraf; El-Tantawy, Ahmad; Gad, Hossam; Hefeda, Mohammad

doi:10.1007/s00264-015-2862-z

Cited by 76 publications

(66 citation statements)

References 27 publications

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“…In general, multiple nerve injuries were found more often than injury to a single nerve [7,8,12,16,19,21,22]. In the study by Robinson et al, injury to the axillary nerve alone was more common in young individuals and as a result of high-energy trauma, while complex neurological deficits were associated with older age, female sex and low-energy fall [5].…”

Section: Affection Of Particular Nervesmentioning

confidence: 97%

“…Axillary nerve was found to be affected in all patients with neurologic deficit after shoulder dislocation (100%) in several studies [6,7,22,23,51,[67][68][69][70], and in all analysed studies but two (Hems and Mahmood, Stenning et al), it occupied the first place among injuries to the long nerves of the brachial plexus [18,54].…”

Section: Affection Of Particular Nervesmentioning

confidence: 99%

“…In those patients, often being multitrauma victims, multiple other injuries coexist, including fractures of the shoulder girdle, proximal humerus and the first rib, which constitute separate possible causes of injury to the brachial plexus. In the analysed literature, high-energy injury was the cause of shoulder dislocation complicated with BPI in 18-71% of the patients in different studies [5,6,8,9,12,18,19,22,51]. In four studies analysing the largest patient groups, high-energy injury was responsible for 36-43% of the cases [5,18,19,22].…”

Section: Incidencementioning

confidence: 99%

“…Brachial plexus injury was found in 1.2% of multitrauma patients in the study by Midha et al, with shoulder dislocation being responsible for 7% of closed BPIs [53]. Males predominated in all large patient groups (M/F from 1.3:1 in the study by Robinson et al to 6.3:1 among the patients studied by Fox et al) (Table 1) [5,[18][19][20][21][22].…”

Section: Incidencementioning

confidence: 99%

“…The mean patient age in this group is higher (usually over 50 years), there are typically no accompanying fractures (fracture of the greater tuberosity of humerus (GTF) can be present) and nerve injury more often has transient character [5,19,22]. Analysis of the literature revealed simple fall to be the most common cause of BPI after shoulder dislocation (18-86% of the patients in different studies), including 43-67% in the four studies on the largest patient groups [5,18,19,22].…”

Section: Incidencementioning

confidence: 99%

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Brachial plexus injury after shoulder dislocation: a literature review

et al. 2018

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Brachial plexus injuries are among the rarest but at the same time the most severe complications of shoulder dislocation. The symptoms range from transient weakening or tingling sensation of the upper limb to total permanent paralysis of the limb associated with chronic pain and disability. Conflicting opinions exist as to whether these injuries should be treated operatively and if so when surgery should be performed. In this review, available literature dedicated to neurological complications of shoulder dislocation has been analysed and management algorithm has been proposed. Neurological complications were found in 5.4-55% of all dislocations, with the two most commonly affected patient groups being elderly women sustaining dislocation as a result of a simple fall and young men after high-energy injuries, often multitrauma victims. Infraclavicular part of the brachial plexus was most often affected. Neurapraxia or axonotmesis predominated, and complete nerve disruption was observed in less than 3% of the patients. Shoulder dislocation caused injury to multiple nerves more often than mononeuropathies. The axillary nerve was most commonly affected, both as a single nerve and in combination with other nerves. Older patient age, higher energy of the initial trauma and longer period from dislocation to its reduction have been postulated as risk factors. Brachial plexus injury resolved spontaneously in the majority of the patients. Operative treatment was required in 13-18% of the patients in different studies. Patients with suspected neurological complications require systematic control. Surgery should be performed within 3-6 months from the injury when no signs of recovery are present.

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Section: Affection Of Particular Nervesmentioning

confidence: 97%

Section: Affection Of Particular Nervesmentioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

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Brachial plexus injury after shoulder dislocation: a literature review

et al. 2018

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High‐Resolution Ultrasound Imaging of Axillary Nerve and Relevant Injury

Xue

Jiang

et al. 2023

J of Ultrasound Medicine

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ObjectiveTo evaluate the feasibility of axillary nerve (AN) visualization in healthy volunteers and the diagnostic value of AN injury via high‐resolution ultrasonography (HRUS).MethodsAN was examined by HRUS on both sides of 48 healthy volunteers and oriented the transducer according to three anatomical landmarks: quadrilateral space, anterior to subscapular muscle, and posterior to axillary artery. The maximum short‐axis diameter (SD) and cross‐sectional area (CSA) of AN were measured at different levels, and AN visibility was graded by using a five‐point scale. The patients suspected of having AN injury were assessed by HRUS, and the HRUS features of AN injury were observed.ResultsAN can be visualized on both sides in all volunteers. There was no significant difference in SD and CSA of AN at the three levels between the left and right sides or in SD between males and females. However, the CSA of males at different levels was slightly larger than those of females (P < .05). In most volunteers, AN visibility at different levels was excellent or good, and AN was best displayed anterior to subscapular muscle. Rank correlation analysis revealed that the degree of AN visibility had correlation with height, weight, and BMI. A total of 15 patients diagnosed with AN injury, 12 patients showed diffuse swelling or focal thickening in AN, and 3 patients showed AN discontinuity.ConclusionHRUS is able to reliably visualize AN, and it could be considered as the first choice for diagnosing AN injury.

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

et al. 2019

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Introduction The objectives of this study were to determine normal reference values for ultrasonographic measurement of the cross‐sectional area (CSA) of the axillary nerve and to standardize the measurement methods. Methods Sixty healthy volunteers were evaluated. Ultrasonography was performed with the shoulder positioned in 100°–120° abduction and 90° external rotation. The CSA of the axillary nerve was measured bilaterally. Results The normal CSA of the right axillary nerve was 2.9 ± 1.1 mm2. The side‐to‐side discrepancy was 22.8% ± 17.8%. Discussion These reference values may be helpful for investigating pathologies involving the axillary nerve.

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Prevalence of associated injuries after anterior shoulder dislocation: a prospective study

Abstract: Lesions associated with traumatic anterior glenohumeral dislocations are more frequent than expected. Thorough clinical examination and detailed imaging including US and MRI are mandatory to avoid a missed diagnosis.

Cited by 76 publications

References 27 publications

Brachial plexus injury after shoulder dislocation: a literature review

Brachial plexus injury after shoulder dislocation: a literature review

High‐Resolution Ultrasound Imaging of Axillary Nerve and Relevant Injury

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

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