Turkish Journal of Physical Medicine and Rehabilitation 2011 , Vol 57 , Num 2

Brachial Plexus Lesion Due to Pathological Fracture of Clavicle in a Patient With Primary Hyperparathyroidism

Hatice Rana Erdem 1 ,Barış Nacır 2 ,Aynur Karagöz 3 ,Meryem Saraçoğlu 4 ,Ferda Özkan Civelek 5
1 Ahi Evran Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Kırşehir, Türkiye
2 Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye
3 Sağlık Bakanlığı, Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye
4 2nd Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey
5 Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ministry of Health, Ankara, Turkey
DOI : 10.4274/tftr.15045

Primary hyperparathyroidism (PHPT) is the third most common endocrinedisorder. The clinical manifestations primarily involve the kidneys and the skeletal system. Pathologic bone fractures and proximal myopathies are rare conditions associated with PHPT. Early brachial plexus lesion secondary to clavicle fracture is very rare as well. The present case is of importance since it includes all of the three above-mentioned rare conditions. A 43-year-old female patient presented with complaints of pain and weakness in the right arm and limitation of movements in the right shoulder after a minor trauma. According to clinical, laboratory and radiological examination, she was diagnosed as having PHPT and traumatic right brachial plexus lesion due to pathologic fracture of clavicle, as well as hyperparathyroidism associated with secondary osteoporosis and myopathy. The patient underwent parathyroid surgery. After the surgery, a rehabilitation program including range of motion and strengthening exercises was given. PHPT may be diagnosed in an advanced stage of the disease. Therefore, clinicians should keep in mind that PHPT may present with complications of hyperparathyroidism.

Keywords : Primary hyperparathyroidism, pathologic fracture, brachialplexus lesion, myopathy