Axillary Nerve Injury

Aka: Axillary Nerve Injury, Axillary Nerve Lesion, Quadrilateral Space Syndrome, Axillary Nerve Compression

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II. Anatomy

  1. Axillary nerve courses around Humerus and through quadrilateral space on the posterior Shoulder

III. Causes

  1. Shoulder Dislocation
  2. Upward pressure from improper crutch use
  3. Repetitive overuse (pitching, swimming)
  4. Humeral Neck Fracture
  5. Surgery (arthroscopy, rotator cuff repair)

IV. Symptoms

  1. Arm Fatigue on throwing and other overhead activities
  2. Posterolateral upper arm and shoulder Paresthesias

V. Signs

  1. Weak abduction and external rotation at the Shoulder

VI. 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

VII. Management

  1. Shoulder Range of Motion Exercises with posterior capsule Stretching
  2. Avoid heavy lifting
  3. Sport specific biomechanical modification to prevent reinjury
    1. Physical therapy referral
  4. Surgical indications
    1. Nerve Conduction Studies and EMG with no improvement after 3-4 months conservative therapy

VIII. Course

  1. Anticipate a 3-6 month course with therapy

IX. References

  1. Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]
  2. Safran (2004) Am Sports Med 32(4): 1063-76 [PubMed]
  3. Silver (2021) Am Fam Physician 103(5): 275-85 [PubMed]

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Related Studies

Ontology: Injury of axillary nerve (C0161456)

Concepts Injury or Poisoning (T037)
ICD9 955.0
ICD10 S44.3
SnomedCT 157649001, 47185005
English Injury to axillary nerve, Axillary nerve injury, injury of axillary nerve, injury of axillary nerve (diagnosis), Injury axillary nerve, axillary nerve injury, Axillary nerve injury (disorder), Injury of axillary nerve, Injury of axillary nerve (disorder), injury; axillary nerve, n.axillaris; injury
Italian Lesione traumatica del nervo ascellare, Traumatismo del nervo ascellare
Dutch letsel van okselzenuw, letsel; nervus axillaris, n.axillaris; letsel, Letsel van nervus axillaris, okselzenuwletsel
Japanese 腋窩神経損傷, ｴｷｶｼﾝｹｲｿﾝｼｮｳ
German Verletzung des N. axillaris, Verletzung des Achselnervs
Czech Poranění nervus axillaris
Korean 겨드랑 신경의 손상
Hungarian Nervus axillaris sérülés, Axillaris ideg sérülés
Spanish lesión traumática del nervio axilar (trastorno), lesión traumática del nervio axilar, Lesión traumática del nervio axilar
Portuguese Lesão traumática do nervo axilar
French Lésion du nerf axillaire
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Axillary nerve compression (C0338561)

Concepts Pathologic Function (T046)
SnomedCT 230636004
English Axillary nerve compression, Axillary nerve compression (disorder)
Spanish compresión axilar nerviosa (trastorno), compresión axilar nerviosa
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Axillary nerve lesion (C0574903)

Concepts Disease or Syndrome (T047)
SnomedCT 298117009
English Axillary nerve lesion, Axillary nerve lesion (disorder)
Spanish lesión de nervio axilar (trastorno), lesión de nervio axilar
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Shoulder Disorders

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