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Case Reports
. 2022 Aug 31;93(4):e2022285.
doi: 10.23750/abm.v93i4.13435.

Brachial plexus paralysis in a patient with clavicular fracture, medico-legal implications

Stefania Fozzato  1 , Quirino Alessandro Petrucci  2 , Alberto Passeri  3 , Luca Bianco Prevot  4 , Riccardo Accetta  5 , Giuseppe Basile  6
Affiliations
Case Reports

Brachial plexus paralysis in a patient with clavicular fracture, medico-legal implications

Stefania Fozzato et al. Acta Biomed. .

Abstract

Clavicular fractures make up 2.6-4% of all fractures in adults. The most frequent mechanism of injury is a fall with direct trauma to the shoulder during sports or road accidents. These fractures can have acute complications such as vascular lesions, nerve injuries, pneumothorax, and musculoskeletal injury. Primary brachial plexus injuries are rare events, both in the adult and paediatric population, have an incidence of less than 1% and are usually caused by direct compression of the fragments. We describe a case of midshaft clavicular fracture treated conservatively with a figure-eight bandage, associated with acute brachial plexus injury, and possible medico-legal repercussions thereof. It is important to recognize the progression of neurological deficits early on, in order for appropriate treatment to be undertaken promptly. Patients must be monitored and re-evaluated within few days after the injury to check the correct positioning of the brace, its degree of tolerability, and the possible onset of neurological deficits, because some clavicular fractures can be associated with compression of the brachial plexus.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
X-ray showing the displaced multi-fragmentary midshaft fracture of left clavicle.
Figure 2.
Figure 2.
MRI image at coronal section. The thickening of brachial plexus bundles is highlighted in red circle.
Figure 3.
Figure 3.
X-ray of clavicle after open reduction and fixation with plate and screws.
See this image and copyright information in PMC

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