Injuries to the upper extremities in polytrauma: limited effect on outcome more than ten years after injury - a cohort study in 629 patients.
OBJECTIVE
To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients.


METHODS
A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion.


RESULTS
In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC.


CONCLUSIONS
Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus. Cite this article: Bone Joint J 2017;99-B:255-60.
Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
C
C
Macke
Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
M
M
Winkelmann
Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
P
P
Mommsen
Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center, Ostmerheimer Str. 200, 51109 Köln, Germany.
C
C
Probst
University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., MC 7774, San Antonio, TX, 78229, USA.
B
B
Zelle
Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
C
C
Krettek
Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany and Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany.
C
C
Zeckey
D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000534:rehabilitation*; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000534:rehabilitation*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000534:rehabilitation* / Q000628:therapy; D000070599:Shoulder Injuries / Q000534:rehabilitation*; D012924:Social Conditions; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000293:injuries*; D055815:Young Adult
Brachial plexus lesion; Long term; Major trauma; Multiple trauma; Polytrauma outcome; Rehabilitation; Upper extremity