Analysis of the nature and severity of injuries in patients with traumatic lesions of the brachial plexus

Authors

  • Serhii Strafun SI «Institute of Traumatology and Orthopaedics of the NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0003-2485-5487
  • Andrii Lysak SI «Institute of traumatology and orthopaedics of NAMS of Ukraine», Kyiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872020240-47

Keywords:

brachial plexus injury, supraclavicular, retroclavicular and subclavicular lesions, risk group for brachial plexus injuries

Abstract

Brachial plexus lesions (BPL) is a severe, disabling pathology is mostly occur in young patients of working age. Often, BPL is combined with other injuries, which significantly aggravate the diagnosis, and therefore delay the start of treatment. Objective: to analyze the characteristics of injuries in patients with traumatic BPI, that has been surgically treated at our center. Methods: retrospective analysis of 237 patients was performed, study included only patients with traumatic brachial plexus injuries, that has been surgically treated at our center, from 2000 to 2019. All patients underwent a thorough anamnesis, orthopedic-neurological examination, radiography, ultrasound, CT, MRI, NCS, ENMG. Particular attention was paid to the etiology, anatomical localization of the lesion, and presence of associated lesions. Results: 84.4 % of patients with BPL had other injuries. In patients of the younger age group (up to 50 y. o.) among the causes of this injury prevailed motorcycle road-traffic accident with root lesions, while in patients after the age of 50 y. o. — fell with injury at the level of cords. Root avulsions are characterized by high energy trauma, while lesions of the brachial plexus cords result from low-energy trauma. Most characteristic of the preganglionic injuries of the brachial plexus were their combination with traumatic brain injury and chest injuries, while for the injury at the level of cords were humerus fractures. Retroclavicular injuries (injury at the devisions level) were characterized by both combination of closed traumatic brain injury and fractures of clavicle and humerus. Conclusions: Most common BPL occur in three critical zones: preganglionic — 36.3 %, subclavicular — 35.4 %, and retroclavicular — 20.3 %. Risk group of patients with BPL should include patients with polytrauma, patients who had injuries traffic accident, falling or significant upper extremity traction.

Author Biography

Serhii Strafun, SI «Institute of Traumatology and Orthopaedics of the NAMS of Ukraine», Kyiv

MD, Prof. in Traumatology and Orthopаedics

References

  1. Kaiser, R., Waldauf, P., Ullas, G., & Krajcová, A. (2018). Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: Systematic review and meta-analysis. Neurosurgical Review, 43(2), 443-452. doi: 10.1007/s10143-018-1009-2
  2. Rasulić, L., Savić, A., Lepić, M., Puzović, V., Karaleić, S., Kovačević, V., … Samardžić, M. (2018). Epidemiological characteristics of surgically treated civilian traumatic brachial plexus injuries in Serbia. Acta Neurochirurgica, 160(9), 1837-1845. doi: 10.1007/s00701-018-3640-7
  3. Jain, D. K., Bhardwaj, P., Venkataramani, H., & Sabapathy, S. R. (2012). An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre. Indian Journal of Plastic Surgery, 45(03), 498-503. doi: 10.4103/0970-0358.105960
  4. Siqueira, M. G., & Martins, R. S. (2011). Surgical treatment of adult traumatic brachial plexus injuries: An overview. Arquivos de Neuro-Psiquiatria, 69(3), 528-535. doi: 10.1590/s0004-282x2011000400023
  5. Bhandari, P., Bhatoe, H., Mukherjee, M., & Deb, P. (2012). Management strategy in post traumatic brachial plexus injuries. The Indian Journal of Neurotrauma, 9(1), 19-29. doi: 10.1016/j.ijnt.2012.04.010
  6. Asplund, M., Nilsson, M., Jacobsson, A., & Von Holst, H. (2009). Incidence of traumatic peripheral nerve injuries and amputations in Sweden between 1998 and 2006. Neuroepidemiology, 32(3), 217-228. doi: 10.1159/000197900

How to Cite

Strafun, S., & Lysak, A. (2023). Analysis of the nature and severity of injuries in patients with traumatic lesions of the brachial plexus. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 40–47. https://doi.org/10.15674/0030-59872020240-47

Issue

Section

ORIGINAL ARTICLES