A good outcome following complete injury of the brachial plexus: long-term analysis of the management of two patients.
Restoration of hand function is rarely achieved after a complete closed traction lesion of the supraclavicular brachial plexus. We describe the injury, treatment, rehabilitation and long-term results of two patients who regained good function of the upper limb and useful function in the hand after such an injury. Successful repairs were performed within six days of injury. Tinel's sign proved accurate in predicting the ruptures and the distribution of pain was accurate in predicting avulsion. The severe pain that began on the day of injury resolved with the onset of muscle function. Recovery of muscle function preceded recovery of sensation. Recovery of the function of C and Adelta fibres was the slowest of all.
Dickson
J K
JK
The Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, UK. john.k.dickson@gmail.com
Biant
L C
LC
D000328:Adult; D001132:Arm / Q000294:innervation; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000601:surgery; D018482:Muscle, Skeletal / Q000503:physiopathology; D020127:Recovery of Function; D012684:Sensory Thresholds; D016896:Treatment Outcome; D055815:Young Adult