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