Brachial Plexopathy/Nerve Root Avulsion in a Football Player: The Role of Electrodiagnostics

Joseph H. Feinberg, MD
Department of Physiatry, Hospital for Special Surgery

Jeffrey Radecki, MD
Department of Physiatry, Hospital for Special Surgery

Scott W. Wolfe, MD
Center for Hand and Upper Extremity Surgery, Hospital for Special Surgery

Helene L. Strauss, BA
Center for Hand and Upper Extremity Surgery, Hospital for Special Surgery

Douglas N. Mintz, MD
Department of Radiology and Imaging, Hospital for Special Surgery


Abstract
Electromyography (EMG) studies are a useful tool in anatomical localization of peripheral nerve and brachial plexus injuries. They are especially helpful in distinguishing between brachial plexopathy and nerve root injuries where surgical intervention may be indicated. EMG can also assist in providing prognostic information after nerve injury as well as after nerve repair. In this case report, a football player presented with weakness in his right upper limb after a traction/traumatic injury to the right brachial plexus. EMG studies revealed evidence of both pre- and postganglionic injury to multiple cervical roots. The injury was substantial enough to cause nerve root avulsions involving the C6 and C7 levels. Surgical referral led to nerve grafts targeted at regaining function in shoulder abduction and elbow flexion. After surgery, the patient's progress was monitored utilizing EMG to assist in identifying true axonal regeneration.

This article appears in HSS Journal: Volume 4, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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