Identification and protection of the Axillary nerve



- Discussion:
    - it is essential to locate axillary nerve when performing any anterior shoulder reconstruction;
    - to facilitate nerve identification, place arm in adduction & in neutral rotation;
    - pass a finger along lower aspect of subscapularis, inorder to palpate nerve as it passes medially along subscapularis to palpate axillary nerve coursing inferolaterally;
    - volar aspect of the index finger palpates the nerve proximal to the quadrangular space.
    - note that external rotation and adduction of the arm moves the nerve away from subscapularis tendon and offers further protection;
    - anterior circumflex humeral vessels mark inferior border of subscapularis;
    - incise upper 2 cm of pectoralis tendon to better palpate and visualize nerve;
    - proximally the nerve courses back to the brachial plexus;
    - distally the nerve course to the quadrangular space



The axillary nerve in its relationship to common sports medicine shoulder procedures.  

Traumatic brachial plexus injuries in the adult: Retro and inferior clavicular lesions

Anatomy of the axillary nerve and its relation to inferior capsular shift.  

Prevention of Axillary Nerve Injury in Anterior Shoulder Reconstructions. Use of a Subscapularis Muscle-Splitting Technique and a Review of the Literature




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, July 2, 2012 7:36 pm