Functional outcome of brachial plexus reconstruction after trauma

OBJECTIVE: Traumatic brachial plexopathies can be devastating injuries. In addition to motor and sensory deficits, pain and functional limitations can be equally debilitating. We sought to evaluate functional outcome and quality of life using statistically validated tools. METHODS: The authors identified a consecutive series of patients who underwent surgical repair of a brachial plexus injury by the same surgeon between 1997 and 2004 at the McGill University Health Center. Participating patients were sent a package containing the Short Form 36, the Disability of the Arm, Shoulder, and Hand questionnaire, a pain visual analog scale, and an additional question on their satisfaction with the surgery. Data was recorded and analyzed using statistical software (SPSS version 13.0 for Windows; SPSS, Inc., Chicago, IL). RESULTS: Thirty-one patients with a mean age of 32.7 years at the time of injury participated in this study. The mean time to surgery was 7.5 months, and the mean follow-up period was 42.7 months. Patients who underwent surgery within 6 months of injury scored consistently better on the Disability of the Arm, Shoulder, and Hand questionnaire (P = 0.03) and the Short Form 36 subscale scores. There was no difference between supra- and infraclavicular injuries; however, patients with root avulsion injuries were more likely to have pain (P = 0.04) and scored lower on the Disability of the Arm, Shoulder, and Hand questionnaire (P = 0.05). CONCLUSION: Statistically validated tools can be used to evaluate the quality of life, upper extremity function, and pain after brachial plexus repairs. Root avulsion injuries and delayed surgical repair correlated negatively with functional outcomes.