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Gunshot injuries to the brachial plexus
M M Samardzic1, L G Rasulic, D M Grujicic
1Institute of Neurosurgery, Clinical Center of Serbia, Belgrade, Yugoslavia.
The Journal of Trauma
|November 14, 1997
Summary
Surgical repair of brachial plexus gunshot wounds shows good functional recovery rates with neurolysis and nerve grafting. Success was observed in most upper extremity nerve injuries, with challenges noted in ulnar and radial nerve repairs.
Area of Science:
- Peripheral nerve surgery
- Trauma surgery
- Neurosurgery
Background:
- Gunshot wounds to the brachial plexus pose significant challenges in peripheral nerve surgery.
- Understanding injury characteristics is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To analyze the characteristics of brachial plexus injuries caused by gunshot wounds.
- To evaluate the functional recovery possibilities after surgical treatment of these injuries.
Main Methods:
- Retrospective analysis of 54 patients with 163 injured nerve elements.
- Surgical procedures included exploration, neurolysis, and nerve grafting.
- Functional outcomes assessed using standard grading scores with follow-up >24 months.
Main Results:
- Neurolysis and nerve grafting demonstrated high functional recovery rates (90.2% and 87.8%, respectively).
- Successful outcomes were achieved for injuries of the upper spinal nerves, upper trunk, lateral/posterior cords, and musculocutaneous/axillary nerves.
- Failures were primarily associated with neurolysis or grafting of ulnar and radial nerve lesions.
Conclusions:
- The incidence of complete functional and anatomical loss in brachial plexus injuries appears higher than in previous studies.
- Prognostically favorable injuries, based on location, yield similar results irrespective of the nerve repair technique used.