It also provides a soft tissue sleeve to protect the axillary nerve
from injury during the operation.
Through a single longitudinal incision the anterior branch to the axillary nerve is isolated in the quadrilateral space.
Reconstruction of C5 and C6 brachial plexus avulsion injury by multiple nerve transfers: spinal accessory to suprascapular, ulnar fascicles to biceps branch, and triceps long or lateral head branch to axillary nerve.
The tendon insertion of the subscapularis is preserved; however, the inferior muscular portion (approximately 5 mm to 10 mm) is released from the humeral neck and retracted inferiorly and medially using a Hohmann or substitute curved retractor, placing the axillary nerve in a safe extra-capsular position (Fig.
Through the inferior window, the surgeon's non-dominant hand can palpate the inferior border of the anatomic neck, and a retractor can be placed at this level to protect the glenoid and axillary nerve from the saw blade.
Safe placement on the suprascapular nerve is well described (2) and raises the question whether this technique, in conjunction with a single shot axillary nerve block, would enable extension of postoperative analgesia past 24 hours following arthroscopic supraspinatus repair.
Dr Price describes a new alternative to the interscalene block (ISB), the so-called 'shoulder block' (ShB) (1) which involves selective blockade of both the suprascapular and axillary nerves.
It may be possible to prolong duration in this group by using a suprascapular nerve catheter 2 and single-shot axillary nerve
performed, with care taken not to propagate distally and injure the axillary nerve
No descriptions of axillary nerve
block were available in the literature, so a technique for blocking this nerve as it travels across the posterior surface of the humerus was developed and is described along with a discussion of the author's initial clinical experience
In particular, injuries to the axillary nerve
and artery have been well documented.
21) Both studies stress the importance of recognizing the proximity of the axillary nerve
and its branch to the teres minor, which lies inferior to the glenohumeral joint capsule.
A recent anatomic study has demonstrated the predictability of the position of the axillary nerve
as it crosses the anterior deltoid raphe, which allows it to be isolated and protected, and dissection can be extended distally.
The thoracodorsal nerve to the deltoid muscle for axillary nerve
This paper reports a rare case of transient radial and axillary nerves
palsy related to intraoperative right lateral positioning for Kuntscher intramedullary nail insertion that caused postural cervical traction.