Assessing the Clinical Outcomes of Brachial Plexus Injury Surgery at Ratchaburi Hospital
Keywords:
Brachial plexus injury, Operative treatment, Ratchaburi hospitalAbstract
Background: Brachial plexus injury is the injury of the primary nerves branching from the spinal cord at the neck region (C5-T1). Currently, surgery for this condition takes a considerable amount of time. Therefore, the researcher initiated the nerve surgery at Ratchaburi Hospital.
Objective: To study the preoperative and postoperative outcomes of nerve transfer or nerve repair surgery in patients with brachial plexus injuries and to compare the treatment outcomes among the groups of BPI total arm type, BPI upper arm, and extended upper arm type, and open brachial plexus injury.
Materials and Methods: This retrospective descriptive study included ten patients over 18 years old with brachial plexus injury who underwent neurotization surgery or brachial plexus repair at Ratchaburi Hospital between 2016 and 2023. Data were analyzed using descriptive statistics.
Results: Among the ten patients who underwent surgery for brachial plexus injury, the comparison of postoperative shoulder and elbow range of motion (ROM) at 24 months showed the best ROM in the open brachial plexus injury group. Additionally, when evaluating muscle strength outcomes between the BPI total arm, BPI upper arm, and Open BPI groups, it was found that over 50% of the patients in all three groups achieved M2 level shoulder and elbow strength at 24 months post-surgery. Furthermore, it was found that the Visual Analog Scale (VAS) pain levels in the Open BPI group decreased the most at 24 months post-surgery—nonetheless, there was a difference in VAS pain levels among the three groups.
Conclusions: Nerve transfer surgery (Neurotization) and brachial plexus repair in patients with brachial plexus injuries who did not experience spontaneous recovery improved pain relief and improved shoulder abduction and elbow flexion within 6-12 months post-surgery. This marks a promising beginning for nerve transfer surgeries at Ratchaburi Hospital.
Keywords: Brachial plexus injury, Operative treatment, Ratchaburi hospital
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