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Brachial plexus injury in Thailand: A report of 520 cases

✍ Scribed by Dr. Panupan Songcharoen

Publisher
John Wiley and Sons
Year
1995
Tongue
English
Weight
429 KB
Volume
16
Category
Article
ISSN
0738-1085

No coin nor oath required. For personal study only.

✦ Synopsis

There were 486 male and 34 female patients. Eighty-two percent of the injuries were caused by motorcycle accidents, 9% by other traffic accidents, and 9% by gunshot, stabbing, and other means.

The initial physical examination revealed 332 (63.8%) complete paralyses and 88 (36.2%) incomplete paralyses. One hundred twenty-seven patients were treated conservatively, 43 patients were observed before definitive treatment was given, and 350 patients were treated by operative means.

Four hundred and twenty-one surgical procedures were performed, consisting of 31 4 neurotisations (250 spinal accessory, 14 plexo-plexal, 21 intercostal, 21 phrenic, 4 cervical plexus, 1 long thoracic, and 3 neuromuscular), 38 neurolyses, 23 nerve grafting, 16 free muscle transfers combined with neurotisations, and 30 musculotendinous transfers. Motor functional recovery of patients followed up for more than 2 years was evaluated. Nerve grafting gave 82% good (more than MRC grade 3) and 18% fair and poor recovery. Neurolysis gave 69% good and 31% fair and poor recovery. In patients with neurotisation, the spinal accessory (to suprascapular, axillary, and musculocutaneous), intercostal (to musculocutaneous), phrenic (to suprascapular, axillary, and musculocutaneous), and plexo-plexal methods gave a significant number of good results.

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