Brachial plexus lesions after backpack carriage in young adults

Jyrki Paavo Tapio Mäkelä, Raimo Ramstad, Ville Mattila, Harri Pihlajamäki

Research output: Contribution to journalArticleScientificpeer-review


Carrying a heavy backpack exerts compression on shoulders, with the potential to cause brachial plexopathy. We evaluated the incidence and predisposing factors of compression plexopathy of the shoulder region in 152,095 military conscripts, hypothesizing that a low body mass index and poor physical fitness predispose to the plexus lesion. Reports of conscripts with neural lesions of the upper arm associated with load carriage were reviewed retrospectively for details associated with the condition onset, symptoms, signs, nerve conduction studies, and electromyographic examinations. Height, weight, and physical fitness scores were obtained from their military training data. The incidence of neural compression after shoulder load carriage in Finnish soldiers was 53.7 (95% confidence interval, 39.5-67.8) per 100,000 conscripts per year. The long thoracic nerve was affected in 19, the axillary nerve in 13, the suprascapular nerve in seven, and the musculocutaneous nerve in six patients. Four patients (7%) had hereditary neuropathy with susceptibility to pressure palsies (HNPP). Symptoms were induced by lighter loads in patients with HNPP. Vulnerability to brachial plexopathy was not predictable from body structure or physical fitness level. To prevent these lesions, awareness of the condition and its symptoms should be increased and backpack designs should be improved.
Original languageEnglish
JournalClinical Orthopaedics and Related Research
Issue number452
Pages (from-to)205-209
Number of pages5
Publication statusPublished - 2006
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 312 Clinical medicine

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