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Brachial plexus injuries associated with cervical spine fractures
J F McGowin1, M Schlitt, J J McCloskey
1Department of Orthopedics, University of South Alabama Medical Center, Mobile 36617.
Journal of Spinal Disorders
|June 1, 1989
Summary
Simultaneous brachial plexus injuries and cervical spine fractures are rare but serious. Delayed recognition of brachial plexus damage can occur due to associated head and spinal cord injuries.
Area of Science:
- Orthopedic Surgery
- Neurology
- Trauma Care
Background:
- Cervical spine fractures and brachial plexus injuries are typically considered separate traumatic events.
- Concurrent injuries can complicate diagnosis and treatment, potentially leading to poorer outcomes.
Observation:
- Review of three patients with concomitant upper cervical spine fractures/dislocations and upper brachial plexus root injuries.
- All patients sustained associated head injuries; two also had spinal cord injuries.
- Brachial plexus injury diagnosis was delayed in all cases due to the severity of other injuries.
Findings:
- The probable injury mechanism involves forced cervical spine lateral bending with shoulder depression.
- All patients required surgical fusion or halo bracing for their cervical spine injuries.
- Two patients developed persistent Erb-type palsies, indicating significant brachial plexus damage.
Implications:
- Clinicians must maintain a high index of suspicion for brachial plexus injuries in all patients with cervical spine trauma.
- Early recognition and management are crucial to mitigate long-term neurological deficits.
- This association highlights the need for comprehensive neurological and orthopedic evaluation in severe neck trauma.