MANAGEMENT OF BRACHIAL PLEXUS MISSILE INJURIES.
- Missile injuries are among the most devastating injuries in general traumatology. Traumatic brachial plexus injuries are the most difficult injuries in peripheral nerve surgery, and most complicated to be surgically treated. Nevertheless, missile wounding is the second most common mechanism of brachial plexus injury. The aim was to evaluate functional recovery after surgical treatment of these injuries. Our series included 68 patients with 202 nerve lesions treated with 207 surgical procedures. Decision on the treatment modality (exploration, neurolysis, graft repair, or combination) was made upon intraoperative finding. Results were analyzed in 60 (88.2%) patients with 173 (85.6%) nerve lesions followed-up for two years. Functional recovery was evaluated according to functional priorities. Satisfactory functional recovery was achieved in 90.4% of cases with neurolysis and 85.7% of cases with nerve grafting. Insufficient functional recovery was verified in ulnar and radial nerve lesions after neurolysis, and in median and radial nerve lesions when graft repair was done. We conclude that the best time for surgery is between two and four months after injury, except for the gunshot wound associated with injury to the surrounding structures, which requires immediate surgical treatment. The results of neurolysis and nerve grafting were similar.
['Rasulić|Lukas|L|', 'Simić|Vesna|V|', 'Savić|Andrija|A|', 'Lepić|Milan|M|', 'Kovačević|Vojin|V|', 'Puzović|Vladimir|V|', 'Vitošević|Filip|F|', 'Novaković|Nenad|N|', 'Samardžić|Miroslav|M|', 'Rotim|Krešimir|K|']
D000293:Adolescent D000328:Adult D001917:Brachial Plexus D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009407:Nerve Block D019635:Neurosurgical Procedures D059348:Peripheral Nerve Injuries D020127:Recovery of Function D061665:Time-to-Treatment D016896:Treatment Outcome D014947:Wounds and Injuries D014948:Wounds, Gunshot
Brachial plexus Traumatology Nerve block Neurosurgical procedures Recovery of function