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Isolated nerve injuries about the shoulder

S J McIlveen1, X A Duralde, D F D'Alessandro

  • 1Shoulder Service, New York Orthopaedic Hospital, Columbia-Presbyterian Medical Center, New York.

Clinical Orthopaedics and Related Research
|September 1, 1994
PubMed
Summary

Infraclavicular nerve injuries, though rare, can be disabling. Etiology significantly impacts recovery, with blunt trauma and dislocations yielding better outcomes than surgical injuries.

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Area of Science:

  • Orthopedics
  • Neurology
  • Sports Medicine

Background:

  • Infraclavicular nerve injuries are uncommon yet can lead to significant disability.
  • Symptoms like vague shoulder pain and muscle weakness can complicate diagnosis.
  • Muscle atrophy is a common finding in affected patients.

Purpose of the Study:

  • To analyze the outcomes of infraclavicular nerve injuries.
  • To identify factors influencing recovery from these injuries.

Main Methods:

  • Retrospective study of 24 patients with 28 infraclavicular nerve injuries.
  • Included axillary, suprascapular, and musculocutaneous nerve injuries.
  • Follow-up included questionnaires, physical exams, and electromyograms over an average of 60 months.

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Main Results:

  • 21 of 28 injuries showed complete or satisfactory recovery.
  • Etiology was a key factor: blunt trauma (8/10) and dislocations (4/6) had good recovery.
  • Surgical injuries (0/7) had poor outcomes; spontaneous onset had no unsatisfactory results.
  • Initial total denervation and intraoperative damage correlated with poor outcomes.

Conclusions:

  • Recovery from infraclavicular nerve injuries varies based on the cause.
  • Surgical nerve damage is associated with the worst prognosis.
  • Early diagnosis and appropriate management are crucial for improving patient outcomes.