Functional deficits as a result of brachial plexus injury in anterior shoulder dislocation

J Hand Surg Eur Vol. 2021 Sep;46(7):725-730. doi: 10.1177/1753193421993088. Epub 2021 Feb 20.

Abstract

The incidence of brachial plexus injuries in anterior shoulder dislocation remains relatively uncommon. A retrospective study was conducted to observe the natural neurological recovery of patients following these injuries over a 2-year period. Muscle power according to the Medical Research Council scale and sensation were measured from presentation to discharge. In 28 patients, the power grade of proximal muscles supplied by nine injured nerves failed to improve over a median follow-up of 5 months. There was no statistically significant improvement in sensation over a median follow-up of 6 months. Poorer recovery in muscle power score was related to advancing age, whereby every decade increased the risk by approximately 30%. Anterior shoulder dislocation with a plexus injury carries a risk of permanent nerve injury. Patients should be referred for specialist nerve assessment leading to rehabilitation and timely early nerve reconstruction, if indicated.Level of evidence: IV.

Keywords: Brachial plexus injury; anterior shoulder dislocation; motor nerve recovery; nerve injury; neurological deficits.

MeSH terms

  • Brachial Plexus Neuropathies* / etiology
  • Brachial Plexus Neuropathies* / surgery
  • Brachial Plexus*
  • Humans
  • Nerve Transfer*
  • Neurosurgical Procedures
  • Retrospective Studies
  • Shoulder Dislocation* / etiology
  • Shoulder Dislocation* / surgery
  • Treatment Outcome