Late onset brachial plexus paresis due to sub-clavian artery pseudo-aneurysm after closed fracture of clavicle

Late onset brachial plexus paresis caused by compression of sub-clavian artery pseudo-aneurysm has been reported but rarely. We present a 75 year old male with eight months old post traumatic fracture of right clavicle, complicated by pseudo-aneurysm formation of right sub-clavian artery with brachial plexus paresis. Initially the fracture clavicle was managed conservatively in a shoulder arm pouch for three weeks. 8 months later however the patient developed a progressively increasing swelling in the right supra-clavicular fossa with numbness and weakness of right upper extremity. He was managed by removal of pseudo-aneurysm and bridging the arterial defect along its length with end to end anastamosis. Clavicle was fixed with clavicular locking plate.