These authors presented their experience in 869 cases of primary anatomic and reverse total shoulder arthroplasties performed without specific attempts to identify the axillary nerve by visualization or the "tug test".
Six cases (0.7%) were found to have axillary nerve injury recognized within 3 months of arthroplasty.
All of these injuries were neuropraxias and all patients had experienced complete neurologic recovery.
These authors point out that positioning the arm in extension and external rotation (what we call the "danger position") places the nerves running anterior to the humerus - the musculocutaneous and median - under tension. This is especially the case if retractors have been placed anterior to the glenoid, in which position they can increase the tension in these nerves. We avoid holding the arm in this position for more than a minute at the time and then return the arm to a neutral position to "give the nerves a drink".
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How you can support progress in shoulder surgery
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Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link
Use the "Search" box to the right to find other topics of interest to you.
How you can support progress in shoulder surgery
You may be interested in some of our most visited web pages arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
