Here, the patient is unable to move any portion of the upper limb (shoulder, elbow, wrist, fingers). Usually, shrugging of the shoulder is possible as this action requires use of the trapezius muscle, which receives nerve supply from the spinal accessory nerve. This nerve lies outside the brachial plexus and is usually spared in these accidents. If this flail situation persists for a month from the accident, it implies a severe injury to all five nerves of the brachial plexus at a very high level (in the neck close to the vertebral column).