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Brachial Plexus Injury in a 6‐Year‐Old Boy with 100% Displaced Proximal Humeral Metaphyseal Fracture: A Case Presentation
Author(s) -
Jovanovich Elizabeth Nora,
Howard James F.
Publication year - 2017
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2017.05.009
Subject(s) - medicine , brachial plexus , forearm , brachial plexus injury , surgery , weakness , posterior interosseous nerve , reduction (mathematics) , axillary nerve , musculocutaneous nerve , anatomy , palsy , alternative medicine , geometry , mathematics , pathology
Posttraumatic brachial plexopathies can occur following displaced proximal humeral fractures, causing profound functional deficits. Described here is an unusual case of a displaced proximal humeral metaphyseal fracture in a young child. The patient underwent closed reduction and serial casting, but hand weakness and forearm sensory loss persisted. Needle electromyography localized the injury to the mid/proximal arm near the fracture site, resulting in damage to the posterior and medial cords of the brachial plexus with profound involvement of the radial, ulnar, and median nerves and sparing of the axillary nerve. After months of occupational therapy, hand strength improved, with a nearly full return of function. Level of Evidence V