Challenges and Opportunities of Early Brachial Plexus Reconstruction in Polytrauma: Case Report and Review of the Literature.

Background: Assessment and treatment of brachial plexus injury in polytrauma patients is often challenging due to concomitant injuries requiring life-saving interventions. Furthermore, the role of immediate nerve exploration in closed postganglionic nerve injuries remains debated. Case presentation: We present the case of a 21-year-old male with an infraclavicular brachial plexus injury, floating shoulder and axillary artery rupture following a motorcycle accident. Early multidisciplinary intervention included vascular repair, bone stabilization and brachial plexus exploration. Nerve reconstruction using grafts and transfers led to significant functional recovery, preventing degenerative changes, and facilitating early rehabilitation. Conclusions: This case highlights the benefits of early exploration and management of complex brachial plexus injuries in polytrauma patients to improve functional outcomes and quality of life.