Brachial plexus lesions in soldiers--the 'sandbag palsy'. A report of 5 cases.

The development of brachial plexus palsy in 5 young men undergoing military training is described. In all cases the posterior cord was predominantly involved and the lesions were the result of repetitive traction, which occurred when the recruits ran approximately 20 km while carrying 50 kg sandbags behind the neck across the shoulders. In this position the shoulders were abducted and externally rotated, while the forearm was fully pronated, i.e. the palms were facing upwards and the fingers backwards. All patients recovered fully once the offending exercise programme was stopped. Military personnel should modify training methods to prevent such lesions in future.