DOI: 10.36347/sjmcr.2019.v07i01.004

Pages: 12-15

Transfer of coracoid to the anterior glenoid became more popular with various successful results. This case is about the failure of the fixation with MRI (Magnetic Resonance Imaging) shooting and a temporary radial nerve injury due to the screw head. The patient was a 42 years old man presented with radial nerve motor and sensorial injury after shooting of cervical MRI. During a cervical MRI shooting a sudden pain in the shoulder region was started. Lost of radial nerve motor and sensitive innervation entirely, was noted. The plains and CT slices were showing a bony defect in anterior glenoid and hematoma near the brachial plexus. Screw head was pressing on the plexus. Under the clavipectoral fascia, brachial plexus was dissected. The screw had come back and pushed on the radial nerve root, but there was not a complete axonal injury (Figure 2). After 20 cc hematoma aspiration screw pulled out easily while protecting the roots. Coracoid bone autograft was entirely lytic, but there was no anterior instability. A totally 12 months after radial nerve motor and sensorial injury were improved. Bone lysis and sudden screw fail could be seen later in coracoid transfer procedures. There is a major ethical issue in the use of MRI on a patient with a ferromagnetic implant. The patient could have lost his life if the loosened screw had transacted a significant vessel, following the trajectory force of the MRI magnetic field. In that patient's plain graphs must be seen before the MRI shooting. Also, late-term acute neuropathic findings should alert the surgeon about possible implant failure, hematoma or irritation of the screw head of nerve root.