- 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.
Prevention of Axillary Nerve Injury in Anterior Shoulder Reconstructions. Use of a Subscapularis Muscle-Splitting Technique and a Review of the Literature
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