Axillary Brachial Plexus Block Application for Reduction of Radius Head Fracture and Elbow Dislocation which Developed after the Trauma in Vertical Wind Tunnels

Year 2016, , 126 - 129, 01.04.2016

Sedat Bilge Attila Aydin Murtaza Kaya Erdem Cevik Mehmet Eryilmaz Cemile Aydin

https://doi.org/10.5455/umj.20160503021306

Abstract

Introduction: To attain and maintain the level of training and skill necessary for the free-fall stage, vertical wind tunnels VWT are commonly used. Skydiving trials might result in extremity fractures. In order to manage pain, peripheral nerve blocks consisting Axillary Brachial Plexus Block ABPB is a novel technique with shows promising results in this area. Case Presentation: We presented a case on the successful application of an ABPB in the reduction of radius head fracture and elbow dislocation. A 26-year-old male patient fell on his left side, as he could not maintain his position in the VWT. In plain radiography, an oblique fracture line on the left radius head and dislocation on the left elbow were observed. During the examination his Visual Analog Score was identified as 98 mm, and in order for the patient to be able to tolerate the painful procedure, an axillary brachial plexus block was preferred. We were unable to establish in the literature the traumatic injuries that occur in VWTs, as a result of free-fall simulations, or any statistics on such injuries. Conclusion: In emergency rooms, where patient load is heavy and the amount of healthcare personnel is low, peripheral nerve block can be an appropriate choice for the emergency physician before undertaking a painful procedure. It is considered that the application of axillary brachial plexus block for reduction in a case of upper extremity dislocation with fracture that happened during a VWT simulation training was safe and effective.

Keywords

Analgesia, axillary block, regional block, vertical wind tunnels

References

• Amit Khurana, CK Ranjan, Decompression chamber runs for screening and training of HALO paratroopers and training of fighter aircrew, Ind J Aerospace Med 52(2), 2008.
• Young KW, Kim JS, Cho JH, Kim HS, Cho HK, Lee KT. Paratrooper's ankle fracture: posterior malleolar fracture. Clin Orthop Surg. 2015;7:15-21.
• Mautner K, Keel JC. Musculocutaneous nerve injury after simulated freefall in a vertical wind-tunnel: a case report. Arch Phys Med Rehabil. 2007;88:391-3.
• Hodkinson PD. Acute exposure to altitude. J R Army Med Corps. 2011;157:85-91.
• D Dhar, Retrospective Study of Injuries in Military Parachuting MJAFI, Vol. 63, No. 4, 2007
• Oong Z., Cooksley T., Holland M., C5-C6 brachial plexus injury sustained as a result of indoor skydiving, retrieved from http://www.acutemedicine.org.uk/wp-content/uploads /2014/12/Case-Reports-Abstract-Book.pdf
• Koval K, Haidukewych GJ, Service B. Controversies in the Management of Distal Radius Fractures. J Am Acad Orthop Surg. 2014; 22: 566-575.