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6) On inspection, deformity of the chest wall and axillary fold may be noted; however, these findings may not become obvious until swelling and ecchymosis resolve over a period of 3 to 6 weeks.
Findings as pain in the medial side of the upper arm, swelling and ecchymosis, asymmetry, and weakness with adduction and internal rotation are common, but the most useful sign is the absence of the anterior axillary fold evidenced by resisted adduction or passive abduction of the affected arm [12].
The AAL is defined as the perpendicular line on the lateral chest wall from the anterior point of the axillary fold.
Physical examination shows a thin anterior axillary fold or even a sulcus at the deltopectoral groove.