Axillary Nerve Palsy

  • Naime Dilara Özkan
  • Sena Gül Çakır


The axillary nerve is one of the main nerves of the shoulder with motor and sensory function. Due to its anatomical course, axillary nerve is quite vulnerable to injuries, and therefore, its injury is commonly seen in clinics. Clinical presentation is generally typical, and good results can be achieved with proper medical management. In this chapter, we will review the anatomy of axillary nerve as well as the diagnosis and management of axillary nerve injury.


  1. 1.
    Netter FH. Atlas of human anatomy. 6th ed. Philadelphia, PA: Saunders; 2014. p. 416. ISBN: 978-0-8089-2451-7.Google Scholar
  2. 2.
    Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2014. p. 721–6. ISBN: 978-1-4511-1945-9.Google Scholar
  3. 3.
    Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 700–9. ISBN: 978-0-8089-2406-7.Google Scholar
  4. 4.
    Steinmann SP, Moran EA. Axillary nerve injury: diagnosis and treatment. J Am Acad Orthop Surg. 2001;9(5):328–35.CrossRefGoogle Scholar
  5. 5.
    Drake RL, Vogl W, Mitchell AWM. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 681. ISBN: 978-0-8089-2406-7.Google Scholar
  6. 6.
    Netter FH. Atlas of human anatomy. 6th ed. Philadelphia, PA: Saunders; 2014. p. 410. ISBN: 978-0-8089-2451-7.Google Scholar
  7. 7.
    Sirasaporn P. Proximal humerus fracture associated with delayed axillary nerve injury. J Scient Soc. 2016;43(3):147–50.CrossRefGoogle Scholar
  8. 8.
    Ball CM, Steger T, Galatz LM, Yamaguchi K. The posterior branch of the axillary nerve: an anatomic study. J Bone Joint Surg Am. 2003;85-A(8):1497–501.CrossRefGoogle Scholar
  9. 9.
    Perlmutter GS. Axillary nerve injury. Clin Orthop Relat Res. 1999;368:28–36.CrossRefGoogle Scholar
  10. 10.
    Visser CP, Coene LN, Brand R, Tavy DL. Nerve lesions in proximal humeral fractures. J Shoulder Elbow Surg. 2001;10(5):421–7.CrossRefGoogle Scholar
  11. 11.
    Price MR, Tillett ED, Acland RD, Nettleton GS. Determining the relationship of the axillary nerve to the shoulder joint capsule from an arthroscopic perspective. J Bone Joint Surg Am. 2004;86-A(10):2135–42.CrossRefGoogle Scholar
  12. 12.
    Gurushantappa PK, Kuppasad S. Anatomy of axillary nerve and its clinical importance: a cadaveric study. J Clin Diagn Res. 2015;9(3):AC13–7. Scholar
  13. 13.
    Rockwood CA, Matsen FA, Wirth MA, Lippitt SB. The shoulder. 4th ed. Philadelphia, PA: Saunders; 2009. p. 1095–7. ISBN: 978-1-4160-3427-8.Google Scholar
  14. 14.
    Galvin JW, Eichinger JK. Outcomes following closed axillary nerve injury: a case report and review of the literature. Mil Med. 2016;181(3):e291–7. Scholar
  15. 15.
    Atef A, El-Tantawy A, Gad H, Hefeda M. Prevalence of associated injuries after anterior shoulder dislocation: a prospective study. Int Orthop. 2016;40(3):519–24. Scholar
  16. 16.
    Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand. 2001;72(4):365–71.CrossRefGoogle Scholar
  17. 17.
    Rockwood CA, Matsen FA, Wirth MA, Lippitt SB. The shoulder. 4th ed. Philadelphia, PA: Saunders; 2009. p. 1040. ISBN: 978-1-4160-3427-8.Google Scholar
  18. 18.
    Drake RL, Vogl W, AWM M. GRAY’S anatomy for students. 2nd ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 668. ISBN: 978-0-8089-2406-7.Google Scholar
  19. 19.
    Perlmutter GS, Apruzzese W. Axillary nerve injuries in contact sports: recommendations for treatment and rehabilitation. Sports Med. 1998;26(5):351–61.CrossRefGoogle Scholar
  20. 20.
    Patel J, Turner M, Birch R, McCrory P. Rupture of the axillary (circumflex) nerve and artery in a champion jockey. Br J Sports Med. 2001;35(5):361–2. Scholar
  21. 21.
    Dillin L, Hoaglund FT, Scheck M. Brachial neuritis. J Bone Joint Surg Am. 1985;67(6):878–80.CrossRefGoogle Scholar
  22. 22.
    Al Khalili Y, Jain S. Brachial neuritis. StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2018. p. 24.Google Scholar
  23. 23.
    Leschinger T, Hackl M, Buess E, Lappen S, Scaal M, Müller LP, Wegmann K. The risk of suprascapular and axillary nerve injury in reverse total shoulder arthroplasty: an anatomic study. Injury. 2017;48(10):2042–9. Scholar
  24. 24.
    Nishimura M, Kobayashi M, Hamagashira K, Noumi S, Ito K, Kato D, Shimada J. Quadrilateral space syndrome: a rare complication of thoracic surgery. Ann Thorac Surg. 2008;86(4):1350–1. Scholar
  25. 25.
    Duchenne GB. Individual action and use of muscles which move the arm on the shoulder. In: Kaplan EB, translator. Physiology of motion. Philadelphia, PA: WB Saunders; 1964. p. 42–60.Google Scholar
  26. 26.
    Bunts FE. Nerve injuries about shoulder joint. Trans Am Surg Assoc. 1903;21:521–62.Google Scholar
  27. 27.
    Seddon HJ. Three types of nerve injuries. Brain. 1943;66:237.CrossRefGoogle Scholar
  28. 28.
    Madura T. Pathophysiology of peripheral nerve injury. In: Rayegani SM, editor. Basic principles of peripheral nerve disorders. London: InTech; 2012. ISBN: 978-953-51-0407-0.Google Scholar
  29. 29.
    Campbell WW. Evaluation and management of peripheral nerve injury. Clin Neurophysiol. 2008;119(9):1951–65. Scholar
  30. 30.
    Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951;74(4):491–516.CrossRefGoogle Scholar
  31. 31.
    Menorca RMG, Fussell TS, Elfar JC. Peripheral nerve trauma: mechanisms of injury and recovery. Hand Clin. 2013;29(3):317–30.CrossRefGoogle Scholar
  32. 32.
    Safran MR. Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med. 2004;32(3):803–19.CrossRefGoogle Scholar
  33. 33.
    Oberlin C, Chino J, Belkheyar Z. Surgical treatment of brachial plexus posterior cord lesion: a combination of nerve and tendon transfers, about nine patients. Chir Main. 2013;32(3):141–6. Epub 2013 May 23.CrossRefPubMedGoogle Scholar
  34. 34.
    Feinberg JH, Radecki J. Parsonage-Turner syndrome. HSS J. 2010;6(2):199–205. Scholar
  35. 35.
    Kazemi M. Acute traumatic anterior glenohumeral dislocation complicated by axillary nerve damage: a case report. J Can Chiropr Assoc. 1998;42(3):150–5.PubMedCentralGoogle Scholar
  36. 36.
    Reid DC. Sports injury assessment and rehabilitation. New York: Churchill Livingstone; 1992. p. 963–77.Google Scholar
  37. 37.
    Zachazewski JE, Magee DJ, Quillen WS. Athletic injuries and rehabilitation. Philadelphia, PA: Saunders; 1996. p. 520–7.Google Scholar
  38. 38.
    Souza TA. Sports injuries of the shoulder, conservative management. New York: Churchill Livingstone; 1994. p. 342–55.Google Scholar
  39. 39.
    Patel NP, Lyon KA, Huang JH. An update-tissue engineered nerve grafts for the repair of peripheral nerve injuries. Neural Regen Res. 2018;13(5):764–74. Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Naime Dilara Özkan
    • 1
  • Sena Gül Çakır
    • 1
  1. 1.Hacettepe University Faculty of MedicineAnkaraTurkey

Personalised recommendations