Injury mechanisms in supraclavicular stretch injuries of the brachial plexus.
The aim of this study was to describe the mechanisms involved in stretch injuries of the brachial plexus. One hundred and fifty consecutive patients with supraclavicular brachial plexus injuries (BPI) were asked about the mechanism of injury during the actual injury event, particularly about the type of trauma to their shoulder, shoulder girdle and head. Fifty-seven of the patients provided enough information about their accident to allow for analysis of the shoulder trauma. The injury mechanism for all patients having upper root or total palsy (n=46) was described as a direct vertical impact to the shoulder. In 44 of these patients, the trauma followed a motorcycle accident and, in most of them, the patient hit a fixed vertical structure before falling to the ground. The injury mechanism for the lower root palsy cases (n=11) was variable. The most frequent mechanism was forceful anterior shoulder compression by a car seat belt. We found that injury mechanisms differed significantly from the ones commonly discussed in published studies.
Pediatric upper extremity surgery and microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Passeig Sant Joan de Deu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain. Electronic address: drsoldado@cirugiamanoinfantil.com.
Francisco
F
Soldado
Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, Brazil.
Marcos F
MF
Ghizoni
Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, Brazil; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina, Brazil.
Jayme
J
Bertelli
D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D011446:Prospective Studies; D012622:Seat Belts; D000070599:Shoulder Injuries / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000209:etiology
Brachial plexus injury; Brachial plexus traction injuries; Lésion du plexis brachial par traction; Lésion du plexus brachial; Mechanisms of injury; Mécanismes lésionnels