727 Pulmonary Embolism Following Posterior Shoulder Dislocation and Traumatic Brachial Plexus Injury - a Case Report

Abstract Traumatic brachial plexus injuries are considered to be among the rarest but most debilitating complications of shoulder dislocation. In addition, posterior dislocations also rare, accounting for only 2–4% all dislocations. A 40-year-old female patient presented emergency department (ED) with a dislocated right secondary mechanical fall. Plain film X-rays demonstrated dislocation humeral head. The was reduced under procedural sedation. Clinical examination after relocation dense flaccid paralysis affecting dermatomes and myotomes throughout upper limb. Urgent magnetic resonance imaging (MRI) showed oedematous thickening haematoma along plexus, large ‘reverse’ Hill-Sachs lesion, greater tuberosity avulsion fracture glenohumeral capsular tear. referred specialist peripheral nerve injury unit, who advised conduction studies angiogram (MRA) rule out expanding haematoma. MRA scan revealed findings consistent MRI scan, no active bleeding, however thrombus in vein. Two days ED ongoing paralysis, severe neuropathic pain, right-sided chest pain. Blood tests d-dimer >1000. CT pulmonary angiography confirmed extensive bilateral emboli she commenced on appropriate anticoagulation. Association between injury, venous thromboembolism rare sequelae resulting from Further required investigate its incidence establish whether patients should receive VTE prophylaxis as standard.