S H Lim1, J S Lee2, Y H Kim3, T W Kim4, K M Kwon3. 1. Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93-1, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, 16247, Republic of Korea. 2. Department of Rehabilitation Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Geumo-dong, Uijeongbu-Si, Gyeonggi-do, 11765, Republic of Korea. drlee1971@gmail.com. 3. Department of Rehabilitation Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Geumo-dong, Uijeongbu-Si, Gyeonggi-do, 11765, Republic of Korea. 4. National Traffic Injury Rehabilitation Hospital, College of Medicine, The Catholic University of Korea, 260, Jungang-ro, Dogok-ri, Yangpyeong-eup, Yangpyeong-gun, Gyeonggi-do, 12564, Republic of Korea.
Abstract
PURPOSE: We investigated the spontaneous recovery of non-operated traumatic brachial plexus injury (BPI). METHODS: A total of 25 cases of non-operated traumatic BPI were analysed by retrospective review of medical records; in all cases, consecutive electrodiagnostic studies (ES) were conducted from 1 to 4 months and 18 to 24 months post-trauma. Injury severity was assessed using a modified version of Dumitru and Wilbourn's scale (DWS) based on ES. Spontaneous recovery of brachial plexus components per subject was analysed using Wilcoxon's signed-rank test. A two-tailed Fisher's exact or Pearson's Chi-square test was used to examine the associations between initial injury severity (DWS grade 2 vs. 3, complete vs. incomplete), accompanying injury type (open vs. closed), main lesion location (supraclavicular vs. infraclavicular lesion), and spontaneous recovery. RESULTS: The most common cause of BPI was traffic accident (TA) (15 cases, 60%), and the most common type of TA-induced BPI was a motorcycle TA (5 cases), accounting for 20% of all injuries. The second most common type of injury was an occupational injury (6 cases, 24%). Thirty-eight (69%) of 55 injured brachial components in 25 cases had DWS grade 3 and 17 brachial components (31%) had grade 2. The DWS grade of brachial plexus components per subject significantly differed between the first and follow-up ES (p = 0.000). However, initial injury severity, accompanying injury type, and main lesion location were not statistically associated with spontaneous recovery (p > 0.05). CONCLUSIONS: Spontaneous recovery may be possible even in severe traumatic BPI. Multiple factors should be considered when predicting the clinical course of traumatic BPI.
PURPOSE: We investigated the spontaneous recovery of non-operated traumatic brachial plexus injury (BPI). METHODS: A total of 25 cases of non-operated traumatic BPI were analysed by retrospective review of medical records; in all cases, consecutive electrodiagnostic studies (ES) were conducted from 1 to 4 months and 18 to 24 months post-trauma. Injury severity was assessed using a modified version of Dumitru and Wilbourn's scale (DWS) based on ES. Spontaneous recovery of brachial plexus components per subject was analysed using Wilcoxon's signed-rank test. A two-tailed Fisher's exact or Pearson's Chi-square test was used to examine the associations between initial injury severity (DWS grade 2 vs. 3, complete vs. incomplete), accompanying injury type (open vs. closed), main lesion location (supraclavicular vs. infraclavicular lesion), and spontaneous recovery. RESULTS: The most common cause of BPI was traffic accident (TA) (15 cases, 60%), and the most common type of TA-induced BPI was a motorcycle TA (5 cases), accounting for 20% of all injuries. The second most common type of injury was an occupational injury (6 cases, 24%). Thirty-eight (69%) of 55 injured brachial components in 25 cases had DWS grade 3 and 17 brachial components (31%) had grade 2. The DWS grade of brachial plexus components per subject significantly differed between the first and follow-up ES (p = 0.000). However, initial injury severity, accompanying injury type, and main lesion location were not statistically associated with spontaneous recovery (p > 0.05). CONCLUSIONS: Spontaneous recovery may be possible even in severe traumatic BPI. Multiple factors should be considered when predicting the clinical course of traumatic BPI.
Entities:
Keywords:
Brachial plexus neuropathy; Causality; Prognosis; Recovery of function
Authors: Keith A Bengtson; Robert J Spinner; Allen T Bishop; Kenton R Kaufman; Krista Coleman-Wood; Michelle F Kircher; Alexander Y Shin Journal: Hand Clin Date: 2008-11 Impact factor: 1.907
Authors: Roongsak Limthongthang; Abdo Bachoura; Panupan Songcharoen; A Lee Osterman Journal: Orthop Clin North Am Date: 2013-09-06 Impact factor: 2.472