What causes traction neuropathies in the hemiplegic shoulder?

Updated: Feb 08, 2019
  • Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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Patients with hemiplegia who have their flaccid arm in an unsupported, dependent position or patients who have been inappropriately transferred by pulling on the arm, tend to be at increased risk for traction neuropathy.

Wanklyn and coauthors reported a 27% increase in the incidence of shoulder pain in dependent patients after discharge, which may have reflected improper handling at home by caregivers. [25] For this reason, patient and caregiver education regarding proper transfer techniques and correct handling of the hemiplegic arm should be stressed. Severe sensory loss or neglect also tends to increase the risk for such injuries. Kaplan suggested that plexus injury should be considered in a patient who has atypical return of distal function. [34]

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