Question
My brother who is only 22 was recently in a bad car accident he broke his neck c-6 and c-7 along with a broken jaw. He has nerve damage down into his bicep, he is able to move his forearm and hand but can't at all use his upper arm.  He was discharged on july 25th and today is august 10. On his discharge sheet it said that he needed to follow up with a neurologist within 2 weeks.  The closest appointmnet I was able to get was for the 28th.  I have tried the hospital and called 7 different neurologists.  I have not been able to get him an appointment sooner.  Now, my question is should he be seen sooner? Also if a shoulder injury could possibly be pinching the nerve and if that's the reason theres no movement?   Thanks Julie

Answer
Dear Julie,

The likely source of the problem is the nerve supply in the neck, but disruption of the musculocutaneous nerve near the shoulder can have the same effect.  The musculocutaneous nerve is a laterally located terminal branch of the brachial plexus and receives its supply form the C5, C6 and C7 nerve roots in the neck... It runs close to the shoulder, but slightly below and infront.

It is difficult to give an opinion on this without electrodiagnostic testing, which is what the neurologist will preform.  Specifically, he will most likely perform an NCV study to determine at what portion of the nerve supply the injury has occurred, and how severe...that will allow for a more proper understanding of the injury as well as prognosis for recovery. As far as the appointment needing to be sooner, that should not create any additional problems.  However, he will need to start rehab in the neck and shoulder/arm as soon as he has been cleared concerning the fracture site.  Effective rehab is his best chance at regaining usage of the arm.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net