Upper trunk brachial plexopathy. The stinger syndrome.

This study was designed to determine the cause of upper trunk brachial plexopathy, which is referred to as a "stinger" or a "burner." This injury often has been thought to occur secondary to traction when an athlete sustains a lateral flexion injury of the neck. At the United States Military Academy, a 4-phase study was begun with 261 tackle football players (236 intramural- and 25 varsity-level players) to investigate this injury. Electromyography and nerve root stimulation studies were used to delineate the lesion, which was found in a total of 32 players who continued throughout the study. This study demonstrated that a much more common mechanism of injury resulting in the stinger syndrome is probably compression of the fixed brachial plexus between the shoulder pad and the superior medial scapula when the pad is pushed into the area of Erb's point, where the brachial plexus is most superficial. An orthosis was designed to protect the brachial plexus from the compressive force of the shoulder pad. In preliminary trials, this orthosis had been very effective in decreasing the number of episodes in which stinger injuries occurred.