Arcuate osteoplasty for brachial plexus paralysis after plate fixation of mid-clavicle fracture: a case report and literature review

弓形骨成形术治疗锁骨中段骨折钢板内固定术后臂丛神经麻痹:病例报告及文献综述

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Abstract

Brachial plexus paralysis is a rare but serious complication following clavicle fractures that is often linked to neurovascular compression, with an incidence of 0.5% to 9.0%. This report presents a case of brachial plexus paralysis in a 61-year-old woman after surgical fixation of a deformed mid-clavicle fracture with a metal plate. Revision surgery was performed to address the paralysis, involving removal of the metal plate, arcuate osteoplasty to create a smooth arch beneath the clavicle, and re-fixation of the plate with adjusted superior angularity. We used this approach to relieve neurovascular compression and restore thoracic outlet space. Over a period of 1 year, significant recovery and successful fracture union were achieved. This case demonstrates that managing brachial plexus paralysis with revision surgery and osteoplasty can effectively restore both neurological function and bone healing.

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