Complete rupture of brachial plexus

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Inability to move left upper limb following a road traffic accident.

Patient Data

Age: 25 years
Gender: Male

Complete discontinuity of left brachial plexus is seen at the level of trunks with retraction, thickening of distal nerves. Edema and hematoma is seen within interscalene triangle.

Edema and hyperintensity is seen in left supraspinatus and infraspinatus muscles suggesting subacute denervation edema.
Fractures of multiple spinous processes is seen with edema involving posterior
paraspinal muscles, more on right side. 
Fracture of left mid clavicle is seen with small displaced intervening bone fragment and surrounding soft tissue edema.

Case Discussion

This would require surgical grafting and recovery may not be complete.

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