Orthopedics Book


Axillary Nerve Injury

Aka: Axillary Nerve Injury, Quadrilateral Space Syndrome
  1. See Also
    1. Peripheral Nerve Injury
  2. Causes
    1. Shoulder Dislocation
    2. Upward pressure from improper crutch use
    3. Repetitive overuse (pitching, swimming)
    4. Surgery (arthroscopy, rotator cuff repair)
  3. Symptoms
    1. Arm Fatigue on throwing and other overhead activities
    2. Posterolateral upper arm Paresthesias may occur
  4. Signs
    1. Weak abduction and external rotation at the Shoulder
  5. Diagnostics
    1. Nerve Conduction Studies and EMG
      1. Consider repeating at 3-6 months after treatment
    2. Shoulder MRI
      1. Typically only helpful for evaluation of differential diagnosis (e.g. labral disorder)
      2. Compression of axillary nerve is unlikely to be visualized on MRI
  6. Management
    1. Shoulder Range of Motion Exercises with posterior capsule Stretching
    2. Avoid heavy lifting
    3. Sport specific biomechanical modification to prevent reinjury
  7. Course
    1. Anticipate a 3-6 month course with therapy
  8. References
    1. Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]
    2. Safran (2004) Am Sports Med 32(4): 1063-76 [PubMed]

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