Traumatic brachial plexus injuries in Cambodia: Demographics, interventions, and post-operative outcomes

Brachial plexus injury (BPI) is a major cause of disability in low- and middle-income countries due to road traffic accidents. There are no studies reporting the epidemiology of BPIs in Cambodia. Therefore, the purpose of this study was to report the demographics, surgical interventions, and post-operative outcomes of surgically treated BPIs at the Children's Surgical Centre (CSC), Cambodia, and reflect on the service development.

We retrospectively reviewed all surgically treated traumatic BPIs at CSC between January 1, 2012 and April 30, 2025. Extracted data included patient demographics, injury mechanism, BPI subtype, operative details, injury to surgery interval, international involvement, and ≥12-month post-operative elbow flexion and shoulder abduction Medical Research Council (MRC) strength.

303 patients had 419 BPI surgeries at CSC. Mean age was 28.51 years (range: 2 - 61 years) and 279 (92.08%) were males. The aetiology was blunt trauma in 296 (97.68%) and the most common subtype was pan-plexal injury in 176 (58.1%) patients. Mean injury to index surgery interval was 6.66 months. Annual case volume increased up to 2019 and international surgical involvement shifted to Cambodian involvement. At ≥12 months post-operatively, 49/71 (69.01%) and 36/53 (67.92%) achieved ≥3 MRC strength in elbow flexion and shoulder abduction, respectively.

There is a high BPI burden among young males following road traffic accidents in Cambodia. CSC has developed a sustainable, self-sufficient BPI service with encouraging functional outcomes. Future priorities include earlier referral after BPI injury and improved outcome capture.