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Traumatic brachial plexus injury: a study of 510 surgical cases from multicenter services in Guangxi, China

  • Guang-Yao Li
  • Ming-Qiang Xue
  • Jing-Wei Wang
  • Xiang-Yong Zeng
  • Jun Qin
  • Ke ShaEmail author
Original Article - Peripheral Nerves
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Part of the following topical collections:
  1. Peripheral Nerves

Abstract

Background

Traumatic brachial plexus injuries are severe lesions, and the incidence of these injuries has been increasing in recent years.

Methods

The clinical data of 510 operated patients with brachial plexus injury recruited from 74 hospitals in Guangxi from 2004 to 2016 were retrospectively studied.

Results

Our study included 447 males and 63 females, with an average age of 29.04 years. Traffic accidents were the most common cause of injury (64.71%), especially motorcycle accidents. Closed injuries accounted for 88.24% of cases, and 83.53% of patients had associated injuries, the most common of which were fractures (76.27%). The preoperative predictive value of root injury of MRI and CT was 74.71% and 71.28%, respectively. 44.71% of patients underwent an initial operation within 6 months after the trauma. Regarding the surgery, neurolysis alone, brachial plexus reconstruction, and free functioning gracilis graft accounted for 16.67%, 75.50%, and 4.51%, respectively. A total of 415 patients were followed up with an average time of 47.95 (25–68) months, and anxiety or depression were found among 81.20% of them. Two hundred seventy-six patients suffered from nerve pain, with mild pain present in 67.03% of patients. Additionally, 347 patients were followed up for more than 3 years, 76.81% of patients with C5-C6 injury recovery to useful function, and the procedure of neurolysis alone demonstrated the best efficacy (79.45%).

Conclusions

Brachial plexus injury is still a challenging trauma for surgeons, and traffic accidents are the dominant cause. Timely and effective surgery is important for functional limb recovery.

Keywords

Brachial plexus Nerve injury Nerve transfer Clinical outcome Epidemiology 

Abbreviations

BPI

Brachial plexus injury

BP

Brachial plexus

MRI

Magnetic resonance imaging

CT

Computed tomography

VAS

Visual analog scale

LSUMC

Louisiana State University Medical Center

NAP

Nerve action potential

Notes

Disclaimer

The funders had no role in the study design, the data collection and analysis, the decision to publish, or the preparation of the manuscript.

Funding

This study was supported by funds from the Natural Science Foundation of Guangxi, China (2015GXNSFCA1598011-5) and by the Shanghai Key Laboratory of Peripheral Nerve and Microsurgery (17DZ2270500).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human participants and/or animals

Not applicable.

Ethical approval

First Affiliated Hospital of Guangxi Medical University Ethical Review Committee, 2018 (KY-E-047).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Trauma and Hand SurgeryFirst Affiliated Hospital of Guangxi Medical UniversityNanningPeople’s Republic of China

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