Injury to the brachial plexus during Putti-Platt and Bristow procedures. A report of eight cases

R R Richards, A R Hudson, J T Bertoia, J R Urbaniak, J P Waddell
American Journal of Sports Medicine 1987, 15 (4): 374-80
Eight patients with documented recurrent anterior dislocation of the shoulder sustained iatrogenic brachial plexus injuries during either Putti-Platt or Bristow procedures. Two patients also sustained axillary artery injuries. There were six males and two females. Postoperatively, complete paralysis of the musculocutaneous nerve was noted in six cases and incomplete paralysis in one case. Two patients had complete axillary nerve palsies. There were two cases of partial paralysis of the radial, median, and ulnar nerves, respectively. Seven of the patients underwent brachial plexus exploration an average of 16 weeks following their initial operation (range, 4 to 40). Suture material was removed from around or within two musculocutaneous nerves and one ulnar, one median, and one axillary nerve. Two lacerated musculocutaneous nerves were amenable to delayed primary repair. Two musculocutaneous, one median and one axillary nerve required grafting. Injury to the brachial plexus was associated with inadequate knowledge of regional anatomy, blind clamping of axillary artery lacerations, use of axillary incisions which limited exposure, and failure to identify the musculocutaneous nerve during Bristow procedures. If a brachial plexus injury occurs during a Putti-Platt or a Bristow procedure and the lesion does not rapidly, progressively, and completely recover, the brachial plexus should be explored since there is a high likelihood of structural neurologic injury.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"