Citation

Rasulić L, Simić V, Savić A, Lepić M, Kovačević V, Puzović V, Vitošević F, Novaković N, Samardžić M, Rotim K. Acta Clin. Croat. 2018; 57(3): 487-496.

Affiliation

Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; 3Section for Neurosurgery, Department of Surgery, Ćuprija General Hospital, Ćuprija, Serbia; 4Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia; 5Department of Neurosurgery, Kragujevac Clinical Center, Kragujevac, Serbia; 6Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; 7Neuroradiology Department, Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia; 8Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 9University of Applied Health Sciences.

Copyright

(Copyright © 2018, Klinička bolnica "Sestre milosrdnice" : Institut za kliničko-medicinska istrazivanja u Zagrebu)

DOI

10.20471/acc.2018.57.03.12

PMID

31168182

PMCID

PMC6536276

Abstract

- Missile injuries are among the most devastating injuries in general traumatology. Traumatic brachial plexus injuries are the most difficult injuries in peripheral nerve surgery, and most complicated to be surgically treated. Nevertheless, missile wounding is the second most common mechanism of brachial plexus injury. The aim was to evaluate functional recovery after surgical treatment of these injuries. Our series included 68 patients with 202 nerve lesions treated with 207 surgical procedures. Decision on the treatment modality (exploration, neurolysis, graft repair, or combination) was made upon intraoperative finding.

RESULTS were analyzed in 60 (88.2%) patients with 173 (85.6%) nerve lesions followed-up for two years. Functional recovery was evaluated according to functional priorities. Satisfactory functional recovery was achieved in 90.4% of cases with neurolysis and 85.7% of cases with nerve grafting. Insufficient functional recovery was verified in ulnar and radial nerve lesions after neurolysis, and in median and radial nerve lesions when graft repair was done. We conclude that the best time for surgery is between two and four months after injury, except for the gunshot wound associated with injury to the surrounding structures, which requires immediate surgical treatment. The results of neurolysis and nerve grafting were similar.

Language: en

Keywords

Brachial plexus; Nerve block; Neurosurgical procedures; Recovery of function; Traumatology