Upper trunk brachial plexus injuries in contact sports

Cervical nerve pinch syndrome, a neurapraxia of the brachial plexus, is a common occurrence in contact football. The incidence at two universities was approximately 49%. The more serious injury, brachial plexus axonotmesis, has received little attention in the literature. We are reporting 13 cases of brachial plexus axonotmesis. Ten were documented by electromyography. All involved the upper trunk. All but one patient recovered within a 3- to 42-week interval. These brachial plexus axonotmesis injuries may initially present as a cervical nerve pinch syndrome. All significant or repeated cervical nerve pinch injuries should be reexamined at 2 weeks. Those patient with axonotmesis should not be allowed to return to competition until they have achieved normal strength in the involved muscles and the electromyogram shows no signs of active denervation.