Operative treatment with nerve repair can restore function in patients with traction injuries in the brachial plexus.
BACKGROUND
Brachial plexus injuries are usually a result of road traffic accidents and a cause of severe disability that typically affects young adult males. In 2010, a national centre was established for referral of these cases from Danish trauma centres. In this paper, we report on our surgical activity and reflect on the role for this new national centre.


METHODS
Records from all our operated patients were reviewed retrospectively. For outcome analysis, we focused on patients who had sustained traction injuries with a surgical follow-up exceeding one year. We used either nerve grafting or transfers for nerve repairs based on the pattern of nerve injury seen intraoperatively.


RESULTS
Overall, 24 patients were operated, and 12 patients were included in the outcome analysis. The six patients with upper brachial plexus palsies all regained shoulder function and useful elbow flexion. Of the six patients with complete brachial plexus palsies, four regained shoulder function, while only one regained useful elbow function, and this was after nerve transfers.


CONCLUSIONS
Operative treatment provides satisfactory results in patients with upper brachial plexus palsies, while improvement is warranted in patients with complete brachial plexus palsies. Our data suggest that nerve transfers may result in a better functional outcome than nerve grafting. We believe that there is a role for a Danish centre for the treatment of these injuries.


BACKGROUND
not relevant.


BACKGROUND
not relevant.
Neurokirurgisk Afdeling, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense C, Denmark. peter@birkeland.dk.
Jerzy
J
Stiasny
Peter
P
Birkeland
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000601:surgery*; D003718:Denmark; D004551:Elbow Joint / Q000502:physiology / Q000601:surgery; D005260:Female; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer; D019635:Neurosurgical Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012782:Shoulder / Q000502:physiology / Q000601:surgery; D014143:Traction; D016896:Treatment Outcome; D055815:Young Adult