Peripheral nerve lesions in traumatic brain-injured patients.
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Biomedical subjects
Publications and source records attributed to E Moskowitz.
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Isolated traumatic suprascapular nerve palsy without associated fracture is a rare occurrence. Localized segmental muscle atrophy limited to the supraspinatus and infraspinatus muscles associated with weakness in initiating abduction and in external rotation of the shoulder should suggest the diagnosis. Electromyography will confirm the diagnosis by excluding nerve root and brachial plexus involvement with denervation potentials limited to the supraspinatus and infraspinatus muscles.
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General principles in the rehabilitation of a patient with an extremity fracture include: treat the patient, not the x-ray; move all joints not immobilized; prevent disuse atrophy; use gravity to assist in mobilizing a joint; stabilize proximal joints to avoid reverse action of biarticular muscles; permit early protected weight bearing until adequate joint mobility is achieved; appropriately instruct the patient in a home program, and avoid all stretching.
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