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[Axillary nerve paralysis after playing squash. A case report]
J Oberle1, K Kuchelmeister, W Schachenmayr
1Neurochirurgischer Abteilung der Universität Ulm, Bezirkskrankenhaus Günzburg.
Der Nervenarzt
|September 14, 1999
Summary
Excessive sport can cause axillary nerve palsy. Surgical repair with nerve grafts successfully restored deltoid muscle function in a patient with complete axillary nerve injury.
Area of Science:
- Orthopedics
- Neurology
- Sports Medicine
Background:
- Axillary nerve palsy can result from various causes, including trauma and overuse injuries.
- Isolated axillary nerve palsy, particularly after sports activities, requires thorough diagnostic evaluation and management.
- Understanding the mechanism of injury is crucial for effective treatment and prognosis.
Observation:
- A 27-year-old male developed complete axillary nerve palsy after excessive squash playing.
- Electromyography revealed no deltoid muscle reinnervation, indicating a significant nerve injury.
- Intraoperative findings showed a thinned segment of the axillary nerve without viable nerve structures.
Findings:
- Surgical resection of the affected nerve segment and reconstruction using sural nerve grafts were performed.
- Intraoperative electrophysiological testing confirmed the absence of nerve action potentials across the lesion.
- Histological examination revealed the absence of intact nerve structures at the site of injury, suggesting a traction-related etiology.
Implications:
- This case highlights traction injury as a potential cause of isolated axillary nerve palsy in athletes.
- Nerve grafting provides a viable surgical option for restoring function in cases of complete axillary nerve discontinuity.
- Successful reinnervation of the deltoid muscle following surgical intervention demonstrates the potential for functional recovery.