{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T23:00:37Z","timestamp":1780786837718,"version":"3.54.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"abstract":"Abstract<\/jats:title>\n Brachial plexus injury (BPI) following shoulder trauma is an uncommon but potentially disabling complication that is often underrecognized, leading to delayed diagnosis. This study aimed to define the institutional incidence, nerve distribution, and recovery patterns of BPI after shoulder trauma and to identify factors associated with injury severity and recovery.<\/jats:p>\n We performed a retrospective review of adult patients diagnosed with BPI following isolated shoulder trauma at a single academic center from January 2016 to July 2023. Patients with BPI were compared with a randomized cohort of shoulder trauma patients without BPI. Variables included demographics, mechanism of injury, injury pattern, nerve involvement, severity grading, management, and \u22651-year outcomes. BPI severity was categorized using a standardized clinical grading system. Logistic regression was used to evaluate factors associated with severity and predictors of recovery.<\/jats:p>\n Among 6,195 patients with shoulder trauma, 111 (1.8%) were diagnosed with BPI. Patients with BPI were younger than controls (51.5 years vs. 58.8 years, p\u2009=\u20090.004), and fracture\u2013dislocations were more common (p\u2009<\u20090.001). The axillary nerve was most frequently affected (67.1%), followed by radial (41.5%), median (36.6%), ulnar (32.9%), and musculocutaneous nerves (22.0%). Most patients (74.4%) achieved complete recovery within 1 year, and 85.4% were managed nonoperatively. Musculocutaneous nerve injury was associated with reduced odds of recovery (OR: 0.17, p\u2009=\u20090.002), whereas dislocation (OR: 5.43, p\u2009=\u20090.017) and fracture\u2013dislocation (OR: 5.60, p\u2009=\u20090.020) were associated with improved recovery compared with isolated fracture.<\/jats:p>\n BPI occurred in 1.8% of shoulder trauma cases and was most associated with fracture\u2013dislocations. Musculocutaneous nerve injury and female sex were independently associated with a lower likelihood of recovery, whereas dislocation and fracture\u2013dislocation patterns were associated with improved recovery compared with isolated fractures. These findings underscore the importance of early, nerve-specific evaluation and more refined prognostic stratification following shoulder trauma.<\/jats:p>","DOI":"10.1055\/a-2880-0496","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T23:13:54Z","timestamp":1779405234000},"source":"Crossref","is-referenced-by-count":0,"title":["The Unappreciated Morbidity of Brachial Plexus Injuries Following Low Energy Shoulder Trauma: Understanding Risk Factors and Natural History"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9695-9731","authenticated-orcid":false,"given":"Omer","family":"Sadeh","sequence":"additional","affiliation":[{"name":"NYU Langone Health, United States","department":["Department of Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N.","family":"Muller","sequence":"additional","affiliation":[{"name":"NYU Langone Hansj\u00f6rg Wyss, United States","department":["Department of Plastic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter D.","family":"Sobba","sequence":"additional","affiliation":[{"name":"NYU Langone Health, United States","department":["Department of Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Nicholas","sequence":"additional","affiliation":[{"name":"NYU Langone Health, United States","department":["Department of Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques H.","family":"Hacquebord","sequence":"additional","affiliation":[{"name":"NYU Langone Health, United States","department":["Department of Orthopedic Surgery"]},{"name":"NYU Langone Hansj\u00f6rg Wyss, United States","department":["Department of Plastic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/0020-1383(82)90100-0","article-title":"Early complications of acute anterior dislocation of the shoulder in the middle-aged and elderly patient","volume":"13","author":"J R Johnson","year":"1982","journal-title":"Injury"},{"issue":"02","key":"ref2","first-page":"48","article-title":"Fracture dislocation of shoulder with brachial plexus palsy: a case report and review of management options","volume":"7","author":"S Rathore","year":"2017","journal-title":"J Orthop Case Rep"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s10143-018-1001-x","article-title":"Brachial plexus injury after shoulder dislocation: a literature review","volume":"43","author":"O Gutkowska","year":"2020","journal-title":"Neurosurg Rev"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"4512137","DOI":"10.1155\/2018\/4512137","article-title":"Analysis of patient-dependent and trauma-dependent risk factors for persistent brachial plexus injury after shoulder dislocation","volume":"2018","author":"O Gutkowska","year":"2018","journal-title":"BioMed Res Int"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"887","DOI":"10.3390\/diagnostics10110887","article-title":"Distribution of peripheral nerve injuries in patients with a history of shoulder trauma referred to a tertiary care electrodiagnostic laboratory","volume":"10","author":"C H Cho","year":"2020","journal-title":"Diagnostics (Basel)"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00131402-200209000-00001","article-title":"Peripheral nerve injury associated with shoulder trauma: a retrospective study and review of the literature","volume":"4","author":"M W Payne","year":"2002","journal-title":"J Clin Neuromuscul Dis"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1177\/1071100717709575","article-title":"Injury characteristics of low-energy Lisfranc injuries compared with high-energy injuries","volume":"38","author":"C H Renninger","year":"2017","journal-title":"Foot Ankle Int"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1302\/0301-620X.47B1.9","article-title":"Infraclavicular brachial plexus injuries","volume":"47","author":"R D Leffert","year":"1965","journal-title":"J Bone Joint Surg Br"},{"issue":"01","key":"ref9","first-page":"11","article-title":"Surgical treatment of traumatic lesions of the axillary nerve. A retrospective study of 33 cases","volume":"70","author":"J Wehbe","year":"2004","journal-title":"Acta Orthop Belg"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1055\/s-0042-1757752","article-title":"A surgical framework for the management of incomplete axillary nerve injuries","volume":"39","author":"D Chi","year":"2023","journal-title":"J Reconstr Microsurg"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1302\/0301-620X.81B4.0810679","article-title":"The incidence of nerve injury in anterior dislocation of the shoulder and its influence on functional recovery. A prospective clinical and EMG study","volume":"81","author":"C P Visser","year":"1999","journal-title":"J Bone Joint Surg Br"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"1227.e1","DOI":"10.1016\/j.jhsa.2021.09.009","article-title":"Patterns of nerve injury and recovery rates of infraclavicular brachial plexus lesions following anterior shoulder dislocation","volume":"47","author":"F Wu","year":"2022","journal-title":"J Hand Surg Am"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1302\/0301-620X.94B6.28286","article-title":"Injuries of the terminal branches of the infraclavicular brachial plexus: patterns of injury, management and outcome","volume":"94","author":"T E Hems","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3109\/17453677809005762","article-title":"Early complications of primary shoulder dislocations","volume":"49","author":"M Pasila","year":"1978","journal-title":"Acta Orthop Scand"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.wneu.2017.06.059","article-title":"Results of operative treatment of brachial plexus injury resulting from shoulder dislocation: a study with a long-term follow-up","volume":"105","author":"O Gutkowska","year":"2017","journal-title":"World Neurosurg"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1055\/a-2737-5342","article-title":"Reusing motor branches of the neurotized median nerve for functioning free muscle transplantation to augment finger flexion in total brachial plexus palsy","author":"J A Lin","year":"2025","journal-title":"J Reconstr Microsurg"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1055\/a-2085-7661","article-title":"The evolution of the reconstructive strategy for elbow flexion for acute C5, C6 brachial plexus injuries over two decades","volume":"40","author":"Y H Lee","year":"2024","journal-title":"J Reconstr Microsurg"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2880-0496.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T22:32:24Z","timestamp":1780785144000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2880-0496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1055\/a-2880-0496","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,21]]},"published":{"date-parts":[[2026,5,21]]}}}