Scientific articleAbduction in Internal Rotation: A Test for the Diagnosis of Axillary Nerve Palsy
Section snippets
Patients and Methods
In advance of data collection, the local ethics committee approved the protocol of the present study. Patients provided written informed consent before participating, in accordance with the Declaration of Helsinki, which guides biomedical research involving human subjects.
From December 2008 to December 2010, we examined 22 patients with suspected axillary nerve injuries at our hospital. We excluded from the study 4 patients with passive limitation of shoulder abduction and 4 with an associated
Results
All patients reported that initially after the accident their range of motion was incomplete, but that it had improved with time. All patients described fatiguability accompanied by shoulder pain when the affected arm was actively raised above horizontal. This was the main reason for seeking surgical intervention. Two-thirds of the patients were concerned about the shoulder appearance after deltoid atrophy. Eleven patients exhibited 180° of active abduction; the remaining 3 patients exhibited
Discussion
Many surgeons believe that lack of abduction beyond horizontal indicates an axillary nerve lesion.16, 17 We observed that full range of abduction is possible in isolated injuries of the axillary nerve, in accordance with previous case reports.13, 18, 19 Here, we demonstrated abduction above horizontal in a series of 14 patients. All of our patients had isolated axillary nerve palsy without fractures or dislocations. Axonal lesions of the suprascapular nerve have been observed in half of
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