Brachial Trauma

Oi5 = the number of intracranial hemorrhage, extraclavicular fracture, spinal injury, nerve injury (other than facial and brachial plexus), and other birth trauma. 

Karlsson J, Thorstien T, Thorleifsson R, Arnason H (1986) Entrapment of the median nerve and brachial artery after supracondylar fractures of the humerus in children. Arch Orthop Trauma Surg 104 389-391... 

Using a rather unconventional puncture site for catheterization of the axillary vein, at the junction between the axillary and subclavian vein, trauma to the brachial nervous plexus is avoided, particularly when large-diameter catheters, serving for Gianturco stents for instance, are introduced (Dondelinger et al. 1991). As a general rule, venous stents should be placed sequentially, first in a distal position, then more proximally, in relation to the puncture site. When the confluence of the innominate veins is treated, the technique used depends on the anatomy and the type of stents required. Usually, the develop-... 

The lirst rib is probably the rib most commonly involved in somatic dysfunction of all the ribs. It is affected by trauma, stress, and posture as well as by dysfunction ofthe C7-T1 complex. The patient may report "shoulder" pain, stiff neck, upper back or neck pain, and an inability to turn the head while driving. The first rib can impinge the neurovascular bundle as it passes between it and the clavicle through the costoclavicular space. The anterior and middle scalene muscles, which raise the first rib, may likewise compress the brachial plexus when they are in spasm and result in thoracic outlet syndrome symptoms. The patient s symptoms are then described as pain, numbness, or paresthesias ofthe arm or hand on the involved side. The physician needs to be aware that this may cause confusion should the patient demonstrate a herniated cervical disc on magnetic resonance imaging [MRO. The symptoms may be caused by the rib dysfunction rather than the herniated disc, so evaluation ofthe rib for normal motion and treatment of any dysfunction should be performed in these cases. Osteopathic manipulation may save the patient unnecessary surgery. 

Millesi, H 1998. Trauma involving the brachial plexus. Management of peripheral nerve problems. G. E. Omer, M. Spinner and A. L. Van Beek (Eds) Philadelphia, PA, W.B. Saunders Company. 

Generally speaking, the clinically relevant structures of the thoracic outlet region are the brachial plexus nerves, the subclavian artery and the subclavian vein. The causes of brachial plexopathy include trauma, intrinsic and extrinsic tumors, radiation plexopathy and Parsonage-Turner syndrome. The neurovascular structures of the thoracic outlet... 

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