158
· DOS Abstracts
Primary brachial plexus reconstructon outcomes
in 12 consecutive patients with traumatic brachial
plexus injury, treated at the National Center for
Brachial Plexus Injuries in Odense between 2010 and 2013.
Jerzy Stiasny, Anders Lorentsen, Peter Birkeland
Division of Hand Surgery, Orthopaedic Department, Odense University Hospital,
Denmark; Håndsektor, Ortopædkirurgisk Afd. O, OUH; Neurokirurgisk Afd.,
OUH
Background:
The brachial plexus (BP) lesions result in severe functional impair-
ment of the affected exstremity. For that reason improvement in restoration of
the brachial plexus function is strongly desirable.
Purpose / Aim of Study:
- to analyse the results of primary BP reconstruc-
tion at our institution during the first 3 years of activity. - to draw conclusions
considering improvement of the results in the future.
Materials and Methods:
We analysed the data of 12 patients operated on
between 2010 and 2013 with 7 partial and 5 total BP injuries. We performed
a total of 14 operations where a primary BP restructure was done. Average
postoperative follow-up was 27 months, patients were operated on average,
4 months after the injury. In the cases of rupture of the BP structures where
the stumps were available we performed a total of 15 different types of nerve
grafting. In the cases of root avulsion or non graftable roots, a total of 13 dif-
ferent neurotisation types were utilised.
Findings / Results:
In the group of patients with partial BP lesions we achieved,
in all cases, shoulder stabilisation and some shoulder movement. All patients in
this group recovered useful elbow flexion of, at least, grade M3 strength accord-
ing to Medical Research Council scale. In the group of 5 patients with complete
BP injuries we achieved in 2 cases a stable shoulder joint with some abduction
and in 4 cases some of elbow flexion, albeit weak ( grade M1 or M2).
Conclusions:
In our material, satisfactory results were achieved in all cases of
partial BP lesions. In the group of total BP lesions only 1 patient recovered a use-
ful function of the limb. Improvement of the results can be achieved by means
of more frequent use of neurotisation options and long nerve grafts directly into
the target muscles, instead of short grafts within the nerve root and trunks.
105.
