Axillary nerve injuries in children

Isolated axillary nerve injury is uncommon, particularly in children. The m otor deficit of shoulder abduction may not recover spontaneously and can be a substantial handicap. Detection may be difficult initially, as the injur y is masked by trauma such as head injury, and concomitant shoulder injury requiring immobilization. After mobilization, patients learn to partially c ompensate by using alternate muscles. There are few reports of surgical man agement of this nerve injury. Most concern predominantly adults, and the re sults are mixed with on average slightly greater than half having a good re covery (defined as grade 4-5 Medical Research Council muscle power). We pre sent our experience with 4 pediatric patients who had axilliary nerve injur y. Three patients had an interposition nerve graft, and 1 patient underwent neurolysis, All patients recovered to grade 4-5 deltoid muscle power. Chil dren with an axillary nerve injury which fails to recover spontaneously by 4-6 months should strongly be considered for surgical exploration. Copyrigh t (C) 2000 S. Karger AG, Basel.