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Case Reports
. 2022 Apr 30;14(4):e24626.
doi: 10.7759/cureus.24626. eCollection 2022 Apr.

Traumatic Bilateral Brachial Plexus Injury

Zinon Kokkalis  1 , Spyridon Papagiannis  1 , Antonis Kouzelis  1 , George Diamantakis  1 , Andreas Panagopoulos  1
Affiliations
Case Reports

Traumatic Bilateral Brachial Plexus Injury

Zinon Kokkalis et al. Cureus. .

Abstract

Traumatic brachial plexus injuries are serious, life-changing injuries that are becoming more common worldwide. A thorough physical examination, as well as radiologic and electrodiagnostic tests, are all part of the initial evaluation. Parameters such as injury patterns, the timing of intervention, patients' expectations, and pre-injury functional level should always be considered. A bilateral brachial plexus injury is a very uncommon occurrence. To our knowledge, only one case of a bilateral brachial plexus injury associated with trauma has been published in recent literature. We present a rare case of a 19-year-old man who sustained a bilateral brachial plexus injury after a motorbike accident. The patient underwent exploration of the left brachial plexus and a modified Oberlin procedure on his left arm. The right plexus injury was managed conservatively. After a follow-up period of 12 months, the patient completely returned to his previous functional level.

Keywords: bilateral brachial plexus injury; brachial plexus injury; brachial plexus neuropathies; oberlin procedure; upper extremity trauma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. (A) Preoperative X-ray of a right forearm fracture, (B, C) Postoperative X-rays
Figure 2
Figure 2. (A): MRI image showing swelling of the C6, C7, and C8 nerves and hematoma in the surrounding tissues of the left brachial plexus (inside the yellow circle), (B): MRI image showing thickening of the C6, C7 and C8 nerves of the right brachial plexus (inside the yellow circle)
Figure 3
Figure 3. Patient’s position and planning of the two skin incisions for left brachial plexus investigation and modified Oberlin procedure
Figure 4
Figure 4. (A) Nerve roots were intact and mild swelling was present. External neurolysis was performed in the upper and middle trunks, (B): Musculocutaneous and ulnar nerves were identified and dissected, (C): A modified Oberlin procedure was performed. The brachialis motor branch was dissected, and its distal end was sutured with two ulnar nerve fascicles
Figure 5
Figure 5. Full range of motion present at the 12-month follow-up
See this image and copyright information in PMC

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