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Related Experiment Videos

Brachial plexus injury: when to amputate?

M C Wilkinson1, R Birch, G Bonney

  • 1Kingston Hospital, Surrey, UK.

Injury
|October 1, 1993
PubMed
Summary

Amputation may be necessary for severe brachial plexus injuries with irreparable vascular damage or sepsis. Patient choice also leads to elective amputation for limb rehabilitation, though it doesn't relieve nerve injury pain.

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Timing of surgical reconstruction for closed traumatic injury to the supraclavicular brachial plexus.

The Journal of hand surgery, European volume·2014

Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Trauma Care

Background:

  • Traction lesions of the brachial plexus can result in severe, non-functional upper limb injuries.
  • A significant number of patients with such injuries may require surgical intervention, including amputation.

Purpose of the Study:

  • To evaluate the indications and outcomes of upper limb amputation in patients with traction lesions of the brachial plexus.
  • To differentiate between urgent and elective amputation scenarios.

Main Methods:

  • Retrospective review of 750 patients with traction lesions of the brachial plexus treated between 1969 and 1991.
  • Analysis of amputation cases (20 patients) based on indications (vascular injury, sepsis, patient request) and outcomes.

Main Results:

  • Twenty patients (2.67%) underwent upper limb amputation.
  • Urgent amputations were performed in 5 patients due to vascular compromise or sepsis.
  • Elective amputations were performed in 13 patients requesting removal of a non-functional limb.
  • Amputation did not alleviate preganglionic brachial plexus injury pain.

Conclusions:

  • Urgent amputation is indicated for non-restorable perfusion, sepsis, or irreparable limb injury.
  • Elective amputation can be a component of rehabilitation for patients with useless limbs.
  • Pain associated with preganglionic brachial plexus injury is not resolved by amputation.

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