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Case reports: long thoracic nerve palsy after using a single axillary crutch
Michael Thomas Murphy1, Simon Francis Journeaux
1Physiotherapy Department, Mater Adult Hospital, South Brisbane, Queensland, Australia. Michael.Murphy@mater.org.au
Clinical Orthopaedics and Related Research
|February 10, 2006
Summary
Improper use of a single axillary crutch after leg fracture surgery can cause long thoracic nerve palsy. This condition, affecting the shoulder blade, may not resolve even after six months, highlighting the need for careful crutch use guidance.
Area of Science:
- Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- A 42-year-old patient sustained fractures of the left tibia and fibula, necessitating surgical intervention.
- Post-surgery, the patient required restricted weight-bearing and used axillary crutches for mobility.
- Progression of weight-bearing led to the use of a single axillary crutch on the right side.
Observation:
- The patient developed an asymmetric gait pattern due to the unilateral crutch use.
- This gait abnormality caused the axillary crutch to impinge upon the chest wall.
- The impingement resulted in the onset of right-sided long thoracic nerve palsy.
Findings:
- The long thoracic nerve palsy was directly linked to the inappropriate use of a single axillary crutch.
- Six months post-injury, the patient had not experienced recovery from the nerve palsy.
- This case underscores a potential iatrogenic complication associated with axillary crutch use.
Implications:
- Clinicians must educate patients on the correct and safe use of axillary crutches.
- Awareness of potential long thoracic nerve and brachial plexus compromise is crucial when prescribing mobility aids.
- Proper gait training and monitoring are essential to prevent asymmetric weight distribution and secondary injuries.
