Microsurgical outcome in posttraumatic brachial plexus injuries in children

The purpose of the study was to analyze the surgical outcomes in children (≤18 years) with brachial plexus injury operated between April 2008 and March 2012 at our center.

All children <18 years of age admitted to our center and surgically treated with a diagnosis of posttraumatic brachial plexus injury were included in the study. The demographic details of these patients were retrieved from the computerized database of our hospital. The results were analyzed in terms of the mode of injury, type of injury, surgical procedure performed, and motor recovery after the surgery (MRC Grading). Motor recovery with MRC >3/5 was termed as good outcome.

A total of 33 patients were surgically treated. The mean age at presentation was 15.1 (range 4-18) years. Boys constituted 79% (n = 26) of our patient population. High-velocity injury was the commonest mode of injury. Panbrachial injury was the commonest seen in 82% (n = 27) of patients. Mean duration between injury and surgical intervention was 6 (range 2-13, SD ± 2.6) months. Majority of patients underwent neurotization procedure. Mean follow-up was 32 (range 6-51) months.

High-velocity trauma is the most common mode on injury. Global palsy involving all the plexal elements was present in 82% of the children. Neurotization was the most commonly performed surgical procedure. Good motor outcome (MRC grade ≥3/5) was seen in 62% of patients.