TOTBİD Dergisi

TOTBİD Dergisi

2022, Cilt 21, Sayı, 2     (Sayfalar: 237-244)

Surgical techniques and clinical results in neural pathologies around the shoulder

Mehmet Armangil 1, Yener Yoğun 1, Uğur Bezirgan 1

1 Ankara Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Ana Bilim Dalı, El Cerrahisi Bölümü, Ankara

DOI: 10.5578/totbid.dergisi.2022.31
Görüntüleme: 301
İndirme : 608

Although neurological and vascular injuries around the shoulder are not very common, overlooked and undiagnosed cases can cause very serious clinical results and medico-legal problems. In addition, the treatment of such neurological injuries is challenging and is a long period for both the patients and the surgeons. They often occur after motor vehicle accidents, gunshot wounds, in sports involving overhead throwing activities. Mechanisms of nerve damage include ischemia from direct pressure, repetitive microtrauma, compression, or stretch. After injuries of the axillary, musculocutaneous, suprascapular, long thoracic nerves, as well as the supraclavicular and infraclavicular brachial plexus, prominent clinical syndromes may occur around the shoulder. In the absence of bone, soft tissue, or vascular injury, nerve injury should be suspected when a patient complains of pain, weakness, or paresthesia. Surgical treatment is indicated in the presence of vascular injury or in cases of severe pain and muscle paralysis after high-energy trauma. In most cases without open trauma, nerve healing is followed for 3-5 months. Surgical treatment is indicated when there is no evidence of improvement in clinical or nerve conduction studies. This article discusses the management of common nerve injuries around the shoulder and the clinical outcome after surgical treatment.

Anahtar Kelimeler : brachial plexus injury; shoulder; nerve transfer; nerve injury