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  • Traumatic Brachial Plexus Injuries: Epidemiological Study at Two Egyptian Centers Over 2 Years

    Final Number:

    mohamedseba7777777 elsayed elsebaey Dr

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: Improving the knowledge about the epidemiology of the traumatic brachial plexus injuries (BPI) helps in providing an appropriate assessment and management of these cases. This issue is important especially in those injuries that have much burden on the individual and national income.

    Methods: Eighteen patients who had traumatic brachial plexus injuries were operated upon by our team from January 2014 to December 2015. The retrospective analysis reviewed the age, sex, mode of trauma, pattern of injury, level of injury, associated injuries, time interval between trauma and surgical intervention, type of the surgical procedure, transferred nerves, grafted nerves, functional outcome and the period of follow up. The regular follow up each 3 months is the rule for most of the patients and the data sheet is updated. We lost contact with one of our operated patients as he changed his address. Functional motor power recovery is assessed by using the scale of Medical Research Council (MRC).[6]

    Results: All the patients were males with mean age 31 years, seventy two percent encountered road traffic accidents (RTA), and ninety percent were because of motorbike accidents. Sixty percent showed upper BPI. Neurolysis, nerve grafting and nerve transfer were the surgical procedures that were followed. Functional recovery had been achieved in about sixty percent of the study population.

    Conclusions: Our study gives insight into epidemiological aspects of the BPI in Egypt and the role of our new center in the management of those injuries. Taking into consideration the small number of the study population, the results were shown to be similar to the worldwide acknowledged percentages.

    Patient Care: by improving the hand skill of the involved team and creating more experienced referral brachial plexus center

    Learning Objectives: learning the different surgical approaches and options in the management of the brachial plexus injuries

    References: 1. Sinha, S., D. Pemmaiah, and R. Midha, Management of brachial plexus injuries in adults: Clinical evaluation and diagnosis. Neurol India, 2015. 63(6): p. 918-25. 2. Goldie, B.S. and C.J. Coates, Brachial plexus injury: a survey of incidence and referral pattern. J Hand Surg Br, 1992. 17(1): p. 86-8. 3. El-Gammal, T.A., et al., Total obstetric brachial plexus palsy: results and strategy of microsurgical reconstruction. Microsurgery, 2010. 30(3): p. 169-78. 4. El-Gammal, T.A., A. El-Sayed, and M.M. Kotb, Surgical treatment of brachial plexus traction injuries in children, excluding obstetric palsy. Microsurgery, 2003. 23(1): p. 14-7. 5. Chang, K.W., et al., A systematic review of evaluation methods for neonatal brachial plexus palsy. J Neurosurg Pediatr, 2013. 6. Limthongthang, R., et al., Adult brachial plexus injury: evaluation and management. Orthop Clin North Am, 2013. 44(4): p. 591-603. 7. Lassarre, S., Analysis of progress in road safety in ten European countries. Accident Analysis and Prevention, 2001. 33(6): p. 743-751. 8. Cho, A.B., et al., Intercostal nerve transfer to the biceps motor branch in complete traumatic brachial plexus injuries. Microsurgery, 2015. 35(6): p. 428-31. 9. Narakas, A.O. and V.R. Hentz, Neurotization in brachial plexus injuries. Indication and results. Clin Orthop Relat Res, 1988(237): p. 43-56. 10. Yun, D.H., et al., Thoracic outlet syndrome caused by schwannoma of brachial plexus. Ann Rehabil Med, 2013. 37(6): p. 896-900. 11. Terzis, J.K. and K.C. Papakonstantinou, The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg, 2000. 106(5): p. 1097-1122; quiz 1123-4. 12. Jain, D.K., et al., An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre. Indian J Plast Surg, 2012. 45(3): p. 498-503. 13. Dubuisson, A.S. and D.G. Kline, Brachial plexus injury: a survey of 100 consecutive cases from a single service. Neurosurgery, 2002. 51(3): p. 673-82; discussion 682-3. 14. Kandenwein, J.A., et al., Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases. J Neurosurg, 2005. 103(4): p. 614-21. 15. Terzis, J.K. and V.K. Kostopoulos, The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg, 2007. 119(4): p. 73e-92e. 16. Brophy, R.H. and S.W. Wolfe, Planning brachial plexus surgery: treatment options and priorities. Hand Clin, 2005. 21(1): p. 47-54. 17. Mansukhani, K.A., Electrodiagnosis in traumatic brachial plexus injury. Ann Indian Acad Neurol, 2013. 16(1): p. 19-25. 18. Yang, G., K.W. Chang, and K.C. Chung, A Systematic Review of Outcomes of Contralateral C7 Transfer for the Treatment of Traumatic Brachial Plexus Injury: Part 2. Donor-Site Morbidity. Plast Reconstr Surg, 2015. 136(4): p. 480e-9e.

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