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Brachial Plexus Palsy After Intramedullary Fixation of a Clavicular FractureA Report of Three Cases
David Ring, MD1; Thomas Holovacs, MD1
1 Hand and Upper Extremity Service (D.R.) and Harvard Shoulder Service (T.H.), Department of Orthopaedic Surgery, Massachusetts General Hospital, Yawkee Center, Suite 2100 (D.R.) and Suite 3200 (T.H.), 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: dring@partners.org
The Journal of Bone & Joint Surgery.  2005; 87:1834-1837  doi:10.2106/JBJS.D.02919
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Extract

Displaced comminuted fractures of the clavicle are associated with an approximately 5% to 10% prevalence of nonunion1-5, and malunion (particularly when associated with >2 cm of shortening) can affect shoulder function1,6-9. While nonoperative treatment of clavicular fractures leads to excellent shoulder function in the vast majority of patients5, some patients with potentially problematic displaced and comminuted fractures now request operative treatment. Intramedullary fixation of the fractured clavicle is recognized as a well-established method of treatment10-14. The present report describes the cases of three patients in whom a brachial plexus palsy developed after intramedullary fixation of a displaced clavicular fracture; to our knowledge, this complication has not been described previously. The patients were informed that data concerning their cases would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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