Serious Axillary Nerve Injury Caused by Subscapular Artery Compression Resulting from Use of Backpacks

Abstract

A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months.

Keywords

axillary nerve palsy - brachial plexus injury - axillary nerve repair - neurorrhaphy - nerve graft repair

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