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Axillary Nerve Injury
Aka: Axillary Nerve Injury, Axillary Nerve Lesion, Quadrilateral Space Syndrome, Axillary Nerve Compression
- See Also
- Peripheral Nerve Injury
- Anatomy
- Axillary nerve courses around Humerus and through quadrilateral space on the posterior Shoulder
- Causes
- Shoulder Dislocation
- Upward pressure from improper crutch use
- Repetitive overuse (pitching, swimming)
- Humeral Neck Fracture
- Surgery (arthroscopy, rotator cuff repair)
- Symptoms
- Arm Fatigue on throwing and other overhead activities
- Posterolateral upper arm and shoulder Paresthesias
- Signs
- Weak abduction and external rotation at the Shoulder
- Diagnostics
- Nerve Conduction Studies and EMG
- Consider repeating at 3-6 months after treatment
- Shoulder MRI
- Typically only helpful for evaluation of differential diagnosis (e.g. labral disorder)
- Compression of axillary nerve is unlikely to be visualized on MRI
- Management
- Shoulder Range of Motion Exercises with posterior capsule Stretching
- Avoid heavy lifting
- Sport specific biomechanical modification to prevent reinjury
- Physical therapy referral
- Surgical indications
- Nerve Conduction Studies and EMG with no improvement after 3-4 months conservative therapy
- Course
- Anticipate a 3-6 month course with therapy
- References
- Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]
- Safran (2004) Am Sports Med 32(4): 1063-76 [PubMed]
- Silver (2021) Am Fam Physician 103(5): 275-85 [PubMed]