A 22-year-old man is brought into the emergency department following a brawl in a tavern. He has severe pain radiating across his back and down his left upper limb. He supports his left upper limb with his right, holding it close to his body. Any attempt to move the left upper limb greatly increases the pain. A radiograph is ordered and reveals an unusual sagittal fracture through the spine of the left scapula. The fracture extends superiorly toward the suprascapular notch. Which nerve is most likely affected?
The suprascapular nerve passes through the suprascapular notch, deep to the superior transverse scapular ligament. This nerve is most likely affected in a fracture of the scapula as described in the question. The thoracodorsal nerve runs behind the axillary artery and lies superficial to the subscapularis muscle and would therefore be protected. The axillary nerve passes posteriorly through the quadrangular space, which is distal to the suprascapular notch. The subscapular nerve originates from the posterior cord of the brachial plexus, which is distal to the site of fracture.
Suprascapular nerve
Thoracodorsal nerve
Axillary nerve
Subscapular nerve
Upper Extremity