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Year |
2002 |
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Question Number |
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Category |
Shoulder and Elbow |
Question
When performing open reduction and internal fixation of a displaced fracture of the scapular neck, which of the following peripheral nerves is at the greatest risk of injury?
1- Axillary
2- Musculocutaneous
3- Upper subscapular
4- Radial
5- Dorsal scapular
Figures
Answer (click for answer)
Correct Answer: 1- Axillary
This is basically an anatomy question. Recall that the axillary nerve runs just inferior to the shoulder joint capsule as is traverses the quadrangular space. Throughout this course it is in close proximity to the scapular neck and so might be in jeopardy during an ORIF. The radial nerve courses more distally through the triangular space. The musculocataneous nerve runs in close proximity to the coracoid process. The upper and lower subscapularis nerves enter the subscapularis muscle proximal to the shoulder joint. The dorsal scapular nerve runs along the medial border of the scapula
Reference: Surgical Exposures in Orthopaedics, 2nd Edition, Hoppenfeld S and deBoer P, 1994, J.B. Lippincott Company, Philadelphia, PA, pp1-49.