抄録
Seventeen cases ( 8 males and 9 females ) of peripheral nerve paralyses associated with fractures or fracture-dislocations of the proximal humerus and dislocations of the shoulder joint were studied. The patients' ages ranged from 17 to 85 years with an average of 56.9 years. The lesions of paralyses consisted of 7 brachial plexuses,7 axillary nerves, one with both axillary nerve and suprascapular nerve and 2 median nerves.
Open reductions were performed in 10, and closed reductions were made in the remaining 7. Two cases underwent surgical explorations of the nerves secondarily after reduction. One had a complete tear of the axillary nerve which was repaired using nerve grafting, and the other had an incomplete tear of the axillary nerve on whom neurolysis was performed.
Thirteen cases were followed electromyographically after reduction. Nine of the 13 had denervations, and 4 of the 13 had polyphasic waves. Among 9 cases, which showed a denervation at the first examination, nascent units were observed within 2 to 4 months after the injury.
Most cases of paralyses associated with fractures or fracture-dislocations of the proximal humerus and dislocations of the shoulder joint recovered spontaneously. However, surgical intervention should be considered for the nerves in those cases without regenerating findings in the EMG within the 4 months after injury.
