Complete brachial plexus lesions: a ten-year follow-up of twenty cases.
Twenty patients with complete brachial plexus lesions were reviewed approximately nine and a half years after injury. Thirteen were amputees and seven had received no surgical treatment. Amputation did not alleviate pain and a prosthesis was frequently of no greater use of the patient than the useless limb it replaced: only two of the thirteen amputees were true prosthetic users and they both had dominant limb involvement, the rest adapting easily to being one-handed. Initial treatment should therefore be conservative, with intensive rehabilitation and retraining. It is recommended that amputation should not be considered until a year after injury and only if the flail limb causes repulsion, prevents sporting activities or if the patient has difficulty in converting to the non-dominant limb. In no instance should smputation be done for relief of pain.
D000671:Amputation, Surgical; D001132:Arm; D001186:Artificial Limbs; D001917:Brachial Plexus / Q000293:injuries*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010146:Pain; D010243:Paralysis / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*