| Objective:To investigate the clavicle fracture associated with brachial plexus injury and its efficacy of early management strategies. Methods:Court since January 2006 to January 2012 admitted cases of clavicle fracture combined with brachial plexus injury out of 27 cases with clavicular fracture associated with the brachial plexus injury were categorized and operated for the fixation of the clavicle fracture and simultaneously explored the brachial plexus as emergency management. Male 18 cases, female 9 cases; age 18-42 year old, average 25.3 years old. The cause of injury:12 cases of traffic accident, falling injury in 10 cases, bruise in 3 cases,2 cases of machinery injuries. Clavicle fractures are divided into three types:including 2 cases of type I, type II 20 cases, type III in 5 cases. Total brachial plexus root avulsion injury in 12 cases,10 cases of bundle branch injury, hematoma formation and local nerve compression or injury in 5 cases. The injury to admission time operation time was 6h-14d, average 4d. Few cases were explored with the membrane lysis haematoma, few operated as nerve anastomosis and remaining were operated as nerve transposition. Results:The patients were followed up for 18 to 36 months, average of 26.3 months. Intraoperative and postoperative did not get any kind of serious complication. In all cases fracture were healed clinically, fracture healing time was 11 to 16 weeks (average 13.4 weeks), shoulder abduction in 8 cases≥ 60°,next 8 cases≥30° and 11 cases<30°. Biceps muscle recovery in 18 cases≥M3 and 9 cases<M3. Wrist flexion or flexor muscle recovery in 12 cases≥M3and 13 cases<M3. Median nerve sensory function recovery in 14 cases≥S3, in 7 cases S1～S2 and 6 cases So. In 2 patients shoulder abduction elbow and wrist flexor motor function recovery is poor. Conclusion:In clavicle fractures associated with brachial plexus injury, even early management for the fixation of fracture and exploration of the brachial plexus injury will give the better result. |
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