Axillary nerve damage in proximal humeral fractures: Clinical and electromyographic study

Objetive: To determine the presence and type of neurological lesions of the axillary nerve in proximal humeral fractures not subjected to surgery. Material and method: A retrospective study was made of 12 patients seen in the emergency room with proximal humeral fractures. A physical examination was carried out with the evaluation of sensitivity and muscle strength (0-5, MRC motor strength scale), and electromyography. Results: The clinical evaluation of sensitivity revealed no alterations in any case. All patients showed diminished muscle strength to one degree or other. The electromyographic data revealed neurological damage in 75% of the subjects-the most common lesion being partial axonotmesis of the axillary nerve. The lesions recovered satisfactorily in all cases. Conclusions: The presence of partial axonotmesis is more common than reflected by the clinical findings. The greater percentage of lesions recorded in our study is possibly related to the fact that electromyography was performed in all cases regardless of the neurological clinical manifestations, revealing lesions that otherwise would not have been detected.