Epidemiology of brachial plexus injuries in a multitrauma population.
نویسنده
چکیده
OBJECTIVE The purpose was to identify the prevalence, causative factors, injury types, and associated injury patterns in multitrauma patients who sustained brachial plexus injuries. METHODS A retrospective review of a prospectively collected and computerized database and a chart review were performed. RESULTS Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting to a regional trauma facility. Young male patients predominated. Motor vehicle accidents were the most frequent cause overall, but only 0.67% of such accidents resulted in plexus injuries. Conversely, 4.2% of motorcycle accident victims and 4.8% of snowmobile accident victims suffered brachial plexus injuries. Injuries were supraclavicular for 62% of patients and infraclavicular for 38%. Supraclavicular injuries were more likely to be severe (Sunderland Grade 3 or 4), compared with infraclavicular injuries, which were neurapraxic in 50% of cases (P < 0.01). The former therefore required surgical exploration and reconstruction more often (52 versus 17%; P < 0.05). Associated injuries included closed head injuries with loss of consciousness in 72% of patients (coma in 19%), cervical spine fractures in 13%, and clavicle, scapular, or humeral fractures and shoulder dislocations or sprains in 15 to 22%. Rib fractures were observed in 41% and were complicated by internal thoracic injuries in a similar percentage of cases. The injury severity score ranged from 5 to 59, with a mean of 24, and two patients died. CONCLUSION Brachial plexus injuries afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%. Head injuries, thoracic injuries, and fractures and dislocations affecting the shoulder girdle and cervical spine are particularly common associated injuries. Supraclavicular injuries are more common, are of more severe grade, more often require surgery, and are associated with worse prognosis, compared with infraclavicular injuries.
منابع مشابه
Epidemiology of brachial plexus injury in the pediatric multitrauma population in the United States.
OBJECT The aim of this study was to estimate the prevalence of brachial plexus injury (BPI) in pediatric multitrauma patients. METHODS The National Pediatric Trauma Registry was queried using the ICD-9 code 953.4, injury to brachial plexus, to identify cases of BPI. The patient demographics, mechanism of trauma, and associated ICD-9 diagnoses were analyzed. RESULTS Brachial plexus injuries ...
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ورودعنوان ژورنال:
- Neurosurgery
دوره 40 6 شماره
صفحات -
تاریخ انتشار 1997