Recovery of brachial plexus injury after shoulder dislocation

Kosiyatrakul, Arkaphat; Jitprapaikulsarn, Surasak; Durand, S.; Oberlin, C.

doi:10.1016/j.injury.2009.05.015

Cited by 37 publications

(47 citation statements)

References 20 publications

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“…Inferior results and longer time required for recovery of the median and ulnar nerves have been observed by many authors [9,18,31,37,77,78].…”

Section: Factors Influencing Recoverymentioning

confidence: 77%

“…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%

“…This complex injury is found more often in patients over 50 years of age and usually coexists with injury to the axillary nerve alone [9,10,15,29,66,70,82]. The incidence of terrible triad varied between 2 and 18% in the analysed literature [5, 10, 11, 13-15, 17, 19, 20, 22] (Table 4).…”

Section: Accompanying Injuriesmentioning

confidence: 99%

“…The worst results regarding motor recovery have been observed for the intrinsic muscles of the hand [6,9,18]. This is caused by a long distance that needs to be covered by regenerating axons and the tendency towards quick atrophy of these muscles [9,18].…”

Section: Recoverymentioning

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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“…Inferior results and longer time required for recovery of the median and ulnar nerves have been observed by many authors [9,18,31,37,77,78].…”

Section: Factors Influencing Recoverymentioning

confidence: 77%

Section: Incidencementioning

confidence: 99%

Section: Accompanying Injuriesmentioning

confidence: 99%

Section: Recoverymentioning

confidence: 99%

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Brachial plexus injury after shoulder dislocation: a literature review

et al. 2018

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“…7,24 These injuries include: cervical radiculitis, spinal accessory nerve injury, long thoracic nerve palsy, burner (stinger) syndrome, suprascapular neuropathy, axillary neuropathy, brachial neuritis and brachial plexus injuries. 24 The diagnosis of shoulder related nerve injury is dependent on proper clinical assessment and imaging techniques. 9 A detailed history of the mechanism of injury is important, as most nerve injuries occur in a specific position.…”

Section: Nerve Injuriesmentioning

confidence: 99%

(i) The diagnosis and treatment of shoulder injuries in contact and collision athletes

Lancker

Martineau

2012

Orthopaedics and Trauma

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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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Recovery of brachial plexus injury after shoulder dislocation

Cited by 37 publications

References 20 publications

Brachial plexus injury after shoulder dislocation: a literature review

Brachial plexus injury after shoulder dislocation: a literature review

(i) The diagnosis and treatment of shoulder injuries in contact and collision athletes

High‐Resolution Ultrasound Imaging of Axillary Nerve and Relevant Injury

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