Results of surgical procedures for brachial plexus injuries due to penetrating trauma

ABSTRACT

The incidence of brachial plexus injuries is on the rise primarily due to the increase in road traffic accidents and the upsurge of violence in our society in general. Inappropriate and poorly timed management can lead to disastrous consequences, not only for the individual but also for the society as a whole. Twenty four patients who received penetrating wounds resulting in damage to the brachial plexus are presented. The time lapse between injury and surgery, level and extent of disability, mode of evaluation and the surgical procedures performed are discussed. Exploration and repair was performed in patients who presented early and in those with total lesions without evidence of recovery. Muscle transfer was the mainstay in patients who presented late and in whom some muscle groups had been spared. The results of surgery have been encouraging although the period of follow-up is relatively short. It is concluded that with the judicious use of intact muscles, nerve repair and grafting in selected cases and extensive physiotherapy useful function can be achieved even in patients with extensive post ganglionic lesions