Clinical and electrophysiological diagnostics of accompanying nerve injuries in the upper arm

The correct diagnosis of a nerve injury and its level in the upper arm is possible with knowledge of the accident pattern, including neurological examination controlling motor and sensory functions of the nerve involved as well as the autonomic regulation and tendon reflexes, and search for a Hoffmann-Tinel sign. Due to the high demands on the patient's compliance, electrophysiological examination of children should only be performed when clinical diagnostics fail, or if the estimated prognosis 2 months after trauma does not prove true. With the electrophysio-logical examination, it is possible to differentiate between neurapraxia, conduction block, and axonotmesis, allowing conclusions about the nerve recovery time to be expected, and finally about the need for surgical intervention. A neurotmesis can be distinguished neither clinically nor electrophysiologically from a complete axonotmesis and in case of doubt needs to be explored surgically.