Both Brachial Plexus Injury and Contralateral Serious Foot Injury due

to a Moto boat accident

Ozgur BAYSAL, Engin ECEVIZ, Fevzi SAGLAM, Halil BEKLER

Dr.Lutfi Kirdar Kartal Training and Research Hospital,Istanbul,TURKEY

Both Brachial Plexus Injury and

Contralateral Serious Foot Injury due to a Moto boat accident

Ozgur BAYSAL, Engin ECEVIZ, Fevzi SAGLAM, Halil BEKLER

Dr.Lutfi Kirdar Kartal Training and Research Hospital,Istanbul,TURKEY

• My disclosure is in the Final AOFAS Mobile App.

• I have no potential conflicts with this presentation.

• A 32-year-old man who was applied to the emergency

department had serious injury on his foot. He was sitting on

the edge of a moto boat. During a fast sharp turn he was

thrown off.

In his physical examination his right foot was cut by propeller blade. In radiographs type 3A calcaneus fracture according to Gustilo-Anderson classification and non displaced metatarsal fractures were established.

• Tetanus prophylaxis was done and suitable antibiotics were

started. We operated this patient immediately. The wounds

were debrided with 10 liters serum physiologic.

• Neurovasculer bundle was dissected. It was intact.

The calcaneus fracture was fixed by 2 k-wires.

• All of the wounds were sutured on his foot.

The neurovascular examination was intact

EARLY POSTOPERATİVE VİEWS

• Two weeks later after accident, he applied to the orthopedic

department for shoulder pain which was newly started.

• In his physical examination passive ROM of shoulder was full

but active ROM of shoulder was incapable.

• The rontgen of shoulder was applied but pathologic findings

weren’t established. Cervical, Brachial Plexus MRI and left

upper extremity EMG were applied.

• Both cervical and brachial plexus MRI was reported normally.

Brachial plexus injury including C5-C6 roots were reported in

EMG examination.

• After operation, the ankle was immobilized by a cast for 6

weeks.

• In the sixth month visit the range of ankle motion was full, the

calcaneus fracture was union and the pain visual analog scale

was 2.

• As for brachial plexus injury the shoulder active ROM was

better. The physical therapy and rehabilitation of the upper

extremity was continued.

6 MONTHS LATER AFTER OPERATION

3 MONTHS LATER AFTER OPERATION (APOLET SIGN)

• The patients who have a boat propeller injuries are usually

applied in Emergency Department in summers.

• Early diagnosis with immediate therapy is the key

determinants of excellent result of open fracture treatment.

• As for brachial plexus upper truncus injuries, which are mostly

treated with physical therapy modalities.

REFERENCES

1.Mendez-Fernandez MA. Motorboat propeller injuries.Ann Plast Surg.1998 Aug;41(2):113-8.

2.Iham Y, Ninomiya K, Noguchi M, Fuke C, Miyazaki T. Fatal propeller injuries: three autopsy case reports. J Forensic Leg Med. 2009 Oct; 16(7): 420-3

3.P. Songchareoen. Management of Brachial Plexus Injury in Adults. Scandinavian Journal of Surgery 97: 317–323, 2008