Tomohiro Saito1, Tomohiro Matusmura2, Katsushi Takeshita2. 1. Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan. Electronic address: tr-saitou@kkf.biglobe.ne.jp. 2. Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
Abstract
BACKGROUND: Brachial plexus palsy after clavicle fracture is extremely rare. We experienced 3 cases of brachial plexus palsy after clavicle fracture and investigated the findings that such patients have in common and the clinical results of these cases. METHODS: We retrospectively analyzed the data of 3 patients with clavicle fracture who had no neurovascular symptoms at the time of the initial injury but gradually developed brachial plexus palsy within 1 month after the injury. The patients were aged 70, 62, and 68 years; 2 patients were male and 1 was female. The patients' backgrounds and clinical results were assessed. RESULTS: All patients had a displaced middle-third clavicle fracture and underwent conservative therapy with a figure-8 bandage. The intervals between fracture and symptoms of brachial plexus palsy were 8, 30, and 14 days. The times from symptoms of brachial plexus palsy to surgery were 27, 75, and 28 days. In all patients, surgery revealed a ruptured subclavius muscle and abnormal development of granulation tissue around the fracture site, compressing the brachial plexus. Open reduction and plate fixation was performed in 2 patients, and clavicle resection was performed in 1 patient. The intervals between surgery and full recovery of muscle strength were 11, 6, and 6 months. CONCLUSION: The findings our 3 patients with brachial plexus palsy after clavicle fracture had in common are old age, middle-third displaced clavicle fracture, and abnormal development of granulation tissue around the fracture site. Surgical intervention yielded good clinical outcomes.
BACKGROUND: Brachial plexus palsy after clavicle fracture is extremely rare. We experienced 3 cases of brachial plexus palsy after clavicle fracture and investigated the findings that such patients have in common and the clinical results of these cases. METHODS: We retrospectively analyzed the data of 3 patients with clavicle fracture who had no neurovascular symptoms at the time of the initial injury but gradually developed brachial plexus palsy within 1 month after the injury. The patients were aged 70, 62, and 68 years; 2 patients were male and 1 was female. The patients' backgrounds and clinical results were assessed. RESULTS: All patients had a displaced middle-third clavicle fracture and underwent conservative therapy with a figure-8 bandage. The intervals between fracture and symptoms of brachial plexus palsy were 8, 30, and 14 days. The times from symptoms of brachial plexus palsy to surgery were 27, 75, and 28 days. In all patients, surgery revealed a ruptured subclavius muscle and abnormal development of granulation tissue around the fracture site, compressing the brachial plexus. Open reduction and plate fixation was performed in 2 patients, and clavicle resection was performed in 1 patient. The intervals between surgery and full recovery of muscle strength were 11, 6, and 6 months. CONCLUSION: The findings our 3 patients with brachial plexus palsy after clavicle fracture had in common are old age, middle-third displaced clavicle fracture, and abnormal development of granulation tissue around the fracture site. Surgical intervention yielded good clinical outcomes.