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Wheeless' Textbook of Orthopaedics
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Identification and protection of the Axillary nerve



- Discussion:
    - it is essential to locate Axillary nerve when performing any anterior shoulder reconstruction;
    - to facilitate nerve identification, place arm in adduction & in neutral rotation;
    - pass a finger along lower aspect of subscapularis, inorder to palpate nerve as it passes medially along subscapularis to
            palpate axillary nerve coursing inferolaterally;
    - volar aspect of the index finger palpates the nerve proximal to the quadrilateral space.
    - note that external rotation and adduction of the arm moves the nerve away from subscapularis tendon and offers further protection;
    - anterior circumflex humeral vessels mark inferior border of subscapularis;
    - incise upper 2 cm of pectoralis tendon to better palpate and visualize nerve;
    - proximally the nerve courses back to the Brachial plexus;
    - distally the nerve course to the Quadrangular Space;




The axillary nerve in its relationship to common sports medicine shoulder procedures.   Bryan WJ, Schaudar K, Tullos HS: Am J Sports Med 1986;14:113.

Traumatic brachial plexus injuries in the adult: Retro and inferior clavicular lesions.  Alnot TY:Clin Orthop 1988;237:9-17.

Anatomy of the axillary nerve and its relation to inferior capsular shift.   R Loomer and B Graham.  CORR. Vol 243. 1989. p 100-105.


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Original Text by Clifford R. Wheeless, III, MD.