Brachial Plexus and Peripheral Nerves Injuries Based on Etiology and Site
Objective; To determine the brachial plexus and peripheral nerves injuries based on etiology and site.
Materials and Methods: This prospective observational study was conducted at neurosurgery department of lady Reading hospital Peshawar from 1st January 2011 to 30th June 2012 with total 1½ year duration. After taking consent from ethical research committee operative records of all those patients were started to document who were admitted in the mentioned duration with brachial plexus and peripheral nerves injuries and documentation was done according to the preformed proforma including age, sex, etiology, type of nerve, site of injury according to operative findings while excluding neuropathies due to compression, metabolic, immunologic causes. Data was analyzed from different angles by SPSS software.
Results: Total 36 patients were included in this study in which 28 were males and 8 were females having age distribution of 10 in first 2 decades, 14 in 3rd decade and remaining 12 patients in 4th – 7th decades. Among 36 cases of peripheral nerves injuries 22 were in upper limbs, 12 in lower limbs and right and left side distribution was equal while the most common cause was fire arm injuries followed by injuries due to the sharp objects .Based on location and nerve involvement the ulnar nerve injury at the wrist joint was most common followed by common peroneal nerve injury at popliteal fossa then sciatic nerve at gluteal region.
Conclusion: Brachial plexus and peripheral nerves injuries occurs mostly due to FAI and sharp objects. in upper limbs Ulnar nerve at wrist joint while in lower limbs common peroneal nerve at popliteal fossa are most commonly injured.
2. Campbell WW. Evaluation and management of peri-pheral nerve injury. Clin Neurophysiol. 2008 Sep; 119 (9): 1951-65.
3. Eser F, Aktekin LA, Bodur H, Atan C. Etiological fac-tors of traumatic peripheral nerve injuries. Neurol India. 2009; 57 (4): 434-7.
4. Ciaramitaro P, Mondelli M, Logullo F, Grimaldi S, Bat-tiston B, Sard A, etc. Traumatic peripheral nerve inju-ries: epidemiological findings, neuropathic pain and quality of life in 158 patients. J Peripher Nerv Syst. 2010 Jun; 15 (2): 120-7. 5. Mark G, Burnett, Zager EL. Pathophysiology of peri-pheral nerve injury: a brief review. Neurosurg Focus. 2004; 16 (5): 1-7. 6. Mafi P, Hindocha S, Dhital M, Saleh M. Advances of peripheral nerve repair techniques to improve hand fun-ction: a systematic review of literature. Open Orthop J. 2012; 6: 60-8. 7. Guido Stoll, Hans Werner Müller. Nerve Injury, Axonal degeneration and neural regeneration: basic insights. Brain Pathol. 1999; 9 (2): 313-25. 8. Tagliafico A, Altafini L, Garello I, Marchetti A, Gen-naro S, Martinoli C. Traumatic neuropathies: spectrum of imaging findings and postoperative assessment. Semin Musculoskelet Radiol. 2010; 14 (5): 512-22.
9. Quan D, Bird SJ. Nerve Conduction Studies and Elec-tromyography in the Evaluation of Peripheral Nerve Injuries. UPOJ. 1999; 12: 45–51.
10. Sakellariou, Badilas NK, Stavropoulos NA, Mazis G, Kotoulas HK, Kyriakopoulos S, et al. Treatment opt-ions for brachial plexus injuries. ISRN Orthop. 2014; 14: 10-1155.
11. Fox IK, Mackinnon SE. Adult peripheral nerve dis-orders — nerve entrapment, repair, transfer and bra-chial plexus disorders. Plast Reconstr Surg. 2011; 127 (5): 10-1097.
12. Birch R, Misra P, Stewart MP, Eardley WG, Ramasamy A, Brown K et al. Nerve injuries sustained during war-fare: part I – epidemiology. J Bone Joint Surg Br. 2012; 94 (4): 523-8.
13. Uzun N, Kiziltan ME, Savrun FK.1999 Marmara earth-quake; peripheral nerve injuries – electrophysiologic evaluation. Electromyogr Clin Neurophysiol. 2005; 45 (1): 3-13.
14. Ahrari MN, Zangiabadi N, Asadi A, Sarafi Nejad A. Prevalence and distribution of peripheral nerve injuries in victims of Bam earthquake. Electromyogr Clin Neu-rophysiol. 2006; 46 (1): 59-62.
15. Yoshida T, Tada K, Uemura K, Yonenobu K. Periphe-ral nerve palsies in victims of the Hanshin – Awaji ear-thquake. Clin Orthop Relat Res. 1999 May; (362): 208-17.
16. Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma. 1998 Jul; 45 (1): 116-22.
17. Kandenwein JA, Kretschmer T, Engelhardt M, Richter HP, Antoniadi G. Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases. J. Neurosurg. 2005: 103 (4): 614-21.
18. Epidemiology of brachial plexus injuries in a multi-trauma population. Neurosurgery, 1997; 40 (6): 1182-89.
19. Krivickas LS, Wilbourn AJ. Peripheral nerve injuries in athletes: a case series of over 200 injuries. Semin Neu-rol. 2000; 20 (2): 225-32.
20. Asplund M. Nilsson M. Jacobsson A. von Holst H. Incidence of traumatic peripheral nerve injuries and amputations in sweden between 1998 and 2006. 2009; 32: 217–28.
Copyright (c) 2018 Pakistan Journal Of Neurological Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.