Abduction in Internal Rotation: A Test for the Diagnosis of Axillary Nerve Palsy

With the trunk bending forward, we asked our patients to actively extend the shoulder, and we extended the shoulders and asked each patient to hold them in that position

Jayme Augusto Bertelli; Marcos Flávio Ghizoni

2011

Scholarcy highlights

  • To describe and validate the use of a test of abduction in internal rotation for the assessment of axillary nerve injury
  • A total of 14 male patients with a mean age of 29 years, with axillary nerve lesions lasting an average of 6 months, participated
  • With the trunk bending forward, we asked our patients to actively extend the shoulder, and we extended the shoulders and asked each patient to hold them in that position
  • For the abduction in internal rotation test, we asked patients to abduct the shoulder in internal rotation
  • If full abduction compared with the normal contralateral side was not possible, the examiner passively held the affected limb in maximal abduction and internal rotation
  • Compensatory abduction in axillary nerve palsy has been attributed to the action of the supraspinatus, biceps, coracobrachialis, and pectoralis major
  • During abduction in internal rotation, compensatory abduction is impaired, clearly indicating deltoid muscle dysfunction

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