Surgical repair of the axillary nerve. Results of a five-year follow-up

We report a series of 19 cases of axillary nerve lesions, which were operated between 1981 and 1995. There were 14 isolated lesions of the axillary nerve and in 5 patients the lesion to the axillary nerve was associated either with a lesion of the radial nerve or with a lesion of the suprascapular nerve. Fourteen patients sustained shoulder stretch injury, three had fractures of the scapular girdle and two anterior shoulder dislocation. Patients were operated on 9 months after trauma through a combined anterior and posterior approach. The lesion was located in the quadrilateral space. In 17 cases the neuroma was excised and the nerve was reconstituted, using sural nerve grafts. In two cases the nerve was only freed from the surrounding scar tissue. Results were considered as satisfactory in 10 out of 14 isolated axillary nerve lesions. According the Constant score there were 2 very good, 8 good and 2 fair results. In this study, neurolysis and axillary nerve associated with suprascapular nerve lesions gave poor results. The successfully reinnervated deltoid muscle adds strength and endurance to the affected shoulder. Electromyographic study remains important in detecting spontaneous return of muscle function and determining the most favorable operative period before severe amyotrophy appears.