Ashman Bradley D, Tewari Anurag, Castle Joshua, Hasan Samer S, Bhatia Sanjeev
Mercy Health-Cincinnati Sports Medicine and Orthopaedic Center, Cincinnati, Ohio.
Evokes, LLC, Mason, Ohio.
JBJS Case Connect. 2018 Oct-Dec;8(4):e85. doi: 10.2106/JBJS.CC.18.00040.
Brachial plexopathy is a rare complication of nonoperatively treated clavicular fractures. We describe a 68-year-old man who presented with fracture-callus-induced acute brachial plexopathy and dynamic thoracic outlet syndrome after 9 weeks of nonoperative management for a clavicular fracture. He underwent fracture fixation with brachial plexus decompression via callus excision; intraoperative neuromonitoring was used to evaluate brachial plexus function. Postsurgery, his neurologic function recovered completely.
Intraoperative neuromonitoring is a useful tool for minimizing the risk of additional brachial plexus injury and determining the adequacy of neural decompression during delayed open reduction and internal fixation of clavicular fractures with fracture-callus-induced brachial plexus compression.
臂丛神经病变是锁骨骨折非手术治疗的一种罕见并发症。我们描述了一名68岁男性，在锁骨骨折非手术治疗9周后出现骨折骨痂引起的急性臂丛神经病变和动态胸廓出口综合征。他接受了骨折固定并通过切除骨痂进行臂丛神经减压；术中使用神经监测来评估臂丛神经功能。术后，他的神经功能完全恢复。
术中神经监测是一种有用的工具，可将锁骨骨折骨痂引起臂丛神经受压的延迟切开复位内固定术中臂丛神经额外损伤的风险降至最低，并确定神经减压是否充分。
