Brachial Plexus Neuropraxia Post Open Reduction and Internal Fixation of Left Acetabulum Fracture.

Abstract

Introduction: Acetabular fractures are often sustained injuries linked to high-energy trauma, such as falls from a considerable height or road traffic incidents. The modified Stoppa technique is currently used approach to treat acetabular fractures. The brachial plexus injury following open reduction and internal fixation (ORIF) of the left acetabulum fracture wasn't reported before.

Case report: Herein we presented a case of a 16-years-old male with a history of road traffic accident sustained an isolated close left acetabulum fracture. X-ray shows associated both column acetabulum fracture with central subluxation. He was managed with open reduction and internal fixation through a modified Stoppa approach with a lateral window. The patient underwent ORIF on the 6th day of the trauma. Fixation was done with plates and screws. At recovery room he could not move whole left upper limb and no sensation while the operated limb DNV was intact. After 15 min of recovery, sensation returned, but motor deficit persisted, indicating brachial plexus neuropraxia. The brain CT scan of was performed and unremarkable finding. After 6 months, the patient restores his sensation on his own, and improved power 5/5 of the left upper limb.

Conclusion: Long stays under general anesthesia and patient position are considerable causes of BPI. Early diagnosis (clinical/imaging) and management typically involve conservative measures, with most patients achieving full recovery. Prevention procedures are essential, including monitoring the patient and proper intraoperative positioning to avoid such nerve injury.