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

Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder. 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. Turk J Phys Med Rehab 2011;57 Suppl 2: 361-5.