DIRECT INJURY TO THE AXILLARY NERVE IN ATHLETES PLAYING CONTACT SPORTS

We performed long-term followup (31 to 276 months) of 11 contact athle tes who had sustained isolated injuries to their axillary nerves durin g athletic competition. There were no known shoulder dislocations. Ele ctromyographs were taken of 10 patients, and all patients had confirma tion of clinically defined injuries that were confined to their axilla ry nerves. Nine injuries were sustained while tackling opposing player s in football; two were sustained in hockey collisions. in seven athle tes, the mechanism of injury was a direct blow to the anterior lateral deltoid muscle. In four athletes, there were simultaneous contralater al neck flexion and ipsilateral shoulder depression. At followup, all patients had residual deficits of axillary sensory and motor nerve fun ction. There had been no deltoid muscle improvement in three patients, moderate improvement in two patients, and major improvement in six pa tients. However, shoulder function remained excellent, with all athlet es maintaining full range of motion and good-to-excellent motor streng th. Axillary nerve exploration and neurolysis in four patients did not significantly affect the outcomes. Although no patient had full recov ery of axillary nerve function, 10 of 11 athletes returned to their pr einjury levels of sports activities, including professional athletics.