The Physiotherapy Management of Postoperative Mid-shaft Clavicular Fracture With Brachial Plexus Injury: A Case Report

TL;DR

This case report describes the physiotherapy management of a woman with a clavicle fracture and brachial plexus injury after a car accident.

Contribution

It presents a multidisciplinary rehabilitation approach combining surgery and physiotherapy for complex postoperative recovery.

Findings

The patient showed improved upper limb function through pain management and muscle re-education.

A structured rehabilitation program helped restore sensory and motor functions in the affected arm.

Early surgical intervention and multidisciplinary care improved functional outcomes and quality of life.

Abstract

Traumatic brachial plexus injury (BPI) is a debilitating condition predominantly affecting young males, often resulting from traction or direct injuries. Due to the complicated neuronal network, the damage is often classified as preganglionic or postganglionic injuries. It includes upper-limb mobility impairments as well as reduced muscular strength and sensitivity. We discuss a case of a 30-year-old female who suffered a displaced mid-shaft clavicular fracture and BPI after a road traffic collision. The patient experienced significant pain, restricted movement, and sensory and motor loss in her left arm. Imaging studies revealed additional complications, including epidural collection and pseudomeningoceles. She underwent open reduction and internal fixation of the clavicle, followed by a structured rehabilitation program focusing on pain management, muscle re-education, and functional recovery.

This case highlights the complexity of managing clavicular fractures with concurrent BPI, requiring a multidisciplinary approach involving imaging, surgical intervention, and comprehensive physiotherapy for optimal recovery and functional restoration. Rehabilitation strategies were employed to address the diverse symptoms, including multi-sensory strategies, sensory re-education, graded motor imagery rehabilitation, and gradual restoration of upper extremity (UE) range, strength, and endurance and to develop neuromuscular control. Effective management of clavicular fractures with BPI requires early diagnosis, surgical intervention, and structured rehabilitation to improve functional outcomes and quality of life.

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