We describe a method of exposing the whole length of the axillary and suprascapular nerves through a sabre-cut incision. The coracoid process is osteotomised and part of trapezius is detached from its insertions. The posterior deltoid is freed from its scapular origin to expose infraspinatus.

We have used this approach to explore combined injuries of the axillary and suprascapular nerves with good results, and no serious complications. Its success depends on a meticulous surgical technique.

We report the results in 33 patients who had nerve grafting of the axillary or the suprascapular nerve or of both. There were 32 men and one woman; their mean age was 21 years and the average interval between injury and operation was three months.

At a mean follow-up of 27 months, the deltoid had recovered to M3 or better in 23 of 30 patients (77%) and the infraspinatus in 18 of 25 patients (72%). Shoulder elevation had reached 120° or more in 27 patients (82%), with external rotation of 30° or more in 27 (82%). Twenty-six patients (79%) could reach to the top of their head with their hand.

Recovery of muscle strength, range of movement and shoulder function were satisfactory when surgery was performed within four months of the injury. Early exploration and nerve grafting can lead to a good functional recovery, but thorough exploration and careful repair of both nerves are essential.