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RESULTS OF NERVE GRAFTING FOR INJURIES OF THE AXILLARY AND SUPRASCAPULAR NERVES

Department of Orthopaedic Surgery, University of Tokyo Hospital Branch, 3-28-6 Mejirodai, Bunkyo-ku, Tokyo 112, Japan.

N. Ochiai, MD, Associate Professor

Department of Orthopaedic Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tnnoudai, Tsukuba-shi, Ibaraki-ken, 305, Japan

S. Yamamoto, MD, Chief

Department of Orthopaedic Surgery, Tokyo Metropolitan Geriatric Hospital, 35 Sakae-chou, Itabashi-ku, Tokyo 173, Japan.

Correspondence should be sent to Dr Y. Mikami.

We report the results in 33 patients who had nerve grafting of the axillary or the suprascapular nerve or of both. There were 32 men and one woman; their mean age was 21 years and the average interval between injury and operation was three months.

At a mean follow-up of 27 months, the deltoid had recovered to M3 or better in 23 of 30 patients (77%) and the infraspinatus in 18 of 25 patients (72%). Shoulder elevation had reached 120° or more in 27 patients (82%), with external rotation of 30° or more in 27 (82%). Twenty-six patients (79%) could reach to the top of their head with their hand.

Recovery of muscle strength, range of movement and shoulder function were satisfactory when surgery was performed within four months of the injury. Early exploration and nerve grafting can lead to a good functional recovery, but thorough exploration and careful repair of both nerves are essential.