A case of bilateral brachial plexus palsy due to shoulder braces

Kent, Christopher; Cheney, Frederick W.

doi:10.1016/j.jclinane.2007.01.010

Cited by 29 publications

(14 citation statements)

References 21 publications

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“…[9] Moreover, the use of axillary crutches and shoulder braces, malpositioning during hospitalization, prone positioning during prolonged surgical procedures, tumors and inflammation were reported as causes of brachial plexus injuries due to differential pressures over nerves. [9][10][11][12] Devitt et al [13] reported flaccid paralysis of upper limb with absence of deep tendon reflexes in an 18-year-old boy, while Silber et al [14] described a complete brachial plexus injury in a 69-year-old gentleman due to stretching following alcohol intoxication.…”

Section: Discussionmentioning

confidence: 99%

Brachial plexus injury: An unusual devastating complication during hospitalization in intensive care unit

Erdem¹

2019

Eklem Hastalik Cerrahisi

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Brakiyal pleksus hasarı: Yoğun bakım ünitesinde yatış sırasında olağandışı yıkıcı bir komplikasyon Brachial plexus injuries lead to functional and physical disability with symptoms ranging from a completely paralyzed upper limb to a lack of muscle control and loss of sensation in the arm, wrist or hand. [1] It has a predominant prevalence in adult male gender and ages between 15 and 25 years. [2] The most common cause of brachial plexus injury in adults is traffic accident, particularly motorcycle accidents. [3,4] Furthermore, traumatic or non-traumatic conditions such as crutch palsy, sports injuries, gunshot wounds, operative malpositioning, tumors, irradiation, alcoholinduced axillary trauma, traction and congenital abnormalities resulting in inflammation are reported as other common reasons causing brachial plexus injury in the literature. [5] Prognosis is variable and associated with the site and extent of the nerve ÖZ Yoğun bakım ünitesi (YBÜ) takibi sırasında kolların hiperabdüksiyon pozisyonunda uzun süre immobilizasyonuna bağlı brakial pleksus hasarı nadirdir. Bu yazıda, YBÜ takibinde aksillası üzerinden sıkıca bağlanmasından dolayı sol üst ekstremitesinde ihmal edilmiş brakiyal pleksus hasarı gelişen, uyuşturucu bağımlısı 20 yaşında bir erkek hastanın olağandışı bir olgusu sunuldu. Sol üst ekstremitesinde progresif hissizliği ve totale yakın immobilitesi vardı. Sol üst ekstremitede atrofi, kas kuvveti kaybı ve derin tendon reflekslerinin olmadığı gözlendi. Elektrodiagnostik çalışmalar, alt gövdede parsiyel aksonal tutulumunun olduğunu gösterdi. Agresif fizik tedavi sonrasında, hastanın kas fonksiyonu iyileşerek medyan, ulnar, muskulokütanöz, aksiller and radyal sinirlerin inerve ettiği tüm kaslarda tam güç gösterdi. Klinisyenler ve diğer personel, YBÜ'de bilinçsiz hastaların takibinde sinir hasarı gibi komplikasyonları göz önünde bulundurarak bu hastaların kısıtlanması konusunda daha dikkatli olmalıdır.

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Section: Discussionmentioning

confidence: 99%

Brachial plexus injury: An unusual devastating complication during hospitalization in intensive care unit

Erdem¹

2019

Eklem Hastalik Cerrahisi

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“…Kent and Cheney [10] reported severe upper trunk brachial plexopathy after the use of shoulder braces with abducted arm position. They experienced decreased perfusion in both arms that was enough to produce a decreased pulse oximetry wave, fluctuation of blood pressure, and decreased radial artery pressure.…”

Section: Discussionmentioning

confidence: 99%

“…But we did not experience any symptom or sign related to decreased circulation. Surveys by the ASA Task Force on the Prevention of Perioperative Peripheral Neuropathies reported that 34% of consultants and ASA members either disagreed or did not know that the use of shoulder braces might impact the risk of brachial plexus injury [10]. …”

Section: Discussionmentioning

confidence: 99%

Severe brachial plexus injury after retropubic radical prostatectomy -A case report-

Song

2012

Korean J Anesthesiol

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A 69-year-old man with prostate cancer underwent surgery for 16 h. Approximately 6 h after surgery, the patient developed severe pain and motor weakness in his right arm. After neurologic examinations that included a nerve conduction study and electromyography, the patient was diagnosed with a brachial plexus injury. The causes of the brachial plexus injury were thought to be abduction of both arms, direct compression of the shoulder brace, and prolonged surgery. Most of the postoperative peripheral nerve injuries due to patient position are preventable, and anesthetists and surgeons should be very careful in positioning the patient accurately.

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“…Literature data dealing with bilateral brachial plexus injuries in general is poor. Kent et al present a case report of bilateral brachial plexus palsy due to shoulder braces in a 32-year-old patient [15] . Grunwald et al also report a bilateral brachial plexus palsy after right-sided modifi ed radical mastectomy with immediate TRAM fl ap reconstruction in the adult [7] .…”

Section: Discussionmentioning

confidence: 99%