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Upper trunk brachial plexus injuries in contact sports
The American Journal of Sports Medicine
|September 1, 1977
Summary
Football players experiencing cervical nerve pinch syndrome (neurapraxia of the brachial plexus) may have a more serious injury called brachial plexus axonotmesis. Early reexamination is crucial for proper diagnosis and safe return to play.
Area of Science:
- Sports Medicine
- Neurology
- Orthopedics
Background:
- Cervical nerve pinch syndrome (brachial plexus neurapraxia) is frequent in contact football, affecting nearly half of players.
- Brachial plexus axonotmesis, a more severe injury, is underreported in scientific literature.
Purpose of the Study:
- To report cases of brachial plexus axonotmesis in football players.
- To highlight the potential initial presentation of axonotmesis as cervical nerve pinch syndrome.
- To establish guidelines for diagnosis and return to play.
Main Methods:
- Case series of 13 football players with brachial plexus axonotmesis.
- Electromyography (EMG) used to document nerve injury in 10 patients.
- Clinical follow-up to assess recovery and return to sport.
Main Results:
- All 13 cases involved the upper trunk of the brachial plexus.
- Ten cases were confirmed by EMG.
- Most patients (12 of 13) recovered within 3 to 42 weeks.
Conclusions:
- Brachial plexus axonotmesis can initially mimic cervical nerve pinch syndrome.
- Significant or repeated cervical nerve pinch injuries warrant reevaluation at 2 weeks.
- Athletes with axonotmesis should only return to competition after full muscle strength recovery and absence of active denervation on EMG.