title: Clinical aspects of patients with traumatic lesions of the brachial plexus following surgical treatment.
abstract: OBJECTIVE
  To evaluate sociodemographic and clinical aspects of patients undergoing operations due to traumatic lesions of the brachial plexus.
  
  
  METHODS
  This was a retrospective study in which the medical files of a convenience sample of 48 patients operated between 2000 and 2010 were reviewed. The following were evaluated: (1) range of motion (ROM) of the shoulder, elbow and wrist/hand, in degrees; (2) grade of strength of the shoulder, elbow and wrist/hand; (3) sensitivity; and (4) visual analogue scale (VAS) (from 0 to 10). The Student's t, chi-square, Friedman, Wilcoxon and Kruskal-Wallis tests were used (p < 0.05).
  
  
  RESULTS
  The patients' mean age was 30.6 years; 60.4% of them had suffered motorcycle accidents and 52.1%, multiple trauma. The mean length of time until surgery was 8.7 months (range: 2-48). Thirty-one patients (64.6%) presented complete rupture of the plexus. The frequent operation was neurosurgery in 39 cases (81.3%). The ROM achieved was ≥30° in 20 patients (41.6%), with a range from 30° to 90° and mean of 73° (p = 0.001). Thirteen (27.1%) already had shoulder strength ≥M3 (p = 0.001). Twenty-seven patients (56.2%) had elbow flexion ≥80°, with a range from 30° to 160° and mean of 80.6° (p < 0.001). Twenty-two had strength ≥M3 (p < 0.001). Twenty-two patients (45.8%) had wrist extension ≥30° starting from flexion of 45°, with a range from 30° to 90° and mean of 70° (p = 0.003). Twenty-seven (56.3%) presented wrist/hand extension strength ≥M3 (p = 0.002). Forty-five (93.8%) had hypoesthesia and three (6.2%) had anesthesia (p = 0.006). The initial VAS was 4.5 (range: 1.0-9.0) and the final VAS was 3.0 (range: 1.0-7.0) (p < 0.001).
  
  
  CONCLUSIONS
  Traumatic lesions of the brachial plexus were more prevalent among young adults (21-40 years), men, people living in urban areas, manual workers and motorcycle accidents, with multiple trauma and total rupture of the plexus. Neurosurgery, with a second procedure consisting of muscle-tendon transfer, was the commonest operation. Surgery for traumatic lesions of the brachial plexus resulted in significant improvement in the ROM and strength of the shoulder, elbow and wrist/hand, improvement of the sensitivity of the limb affected and reduction of the final pain.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
authors.forename: Frederico Barra
authors.initials: FB
authors.lastname: de Moraes
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
authors.forename: Mário Yoshihide
authors.initials: MY
authors.lastname: Kwae
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
authors.forename: Ricardo Pereira
authors.initials: RP
authors.lastname: da Silva
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
authors.forename: Celmo Celeno
authors.initials: CC
authors.lastname: Porto
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
authors.forename: Daniel de Paiva
authors.initials: Dde P
authors.lastname: Magalhães
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
authors.forename: Matheus Veloso
authors.initials: MV
authors.lastname: Paulino
keywords: Accident prevention; Brachial plexus/surgery; Multiple trauma