Gunshot Injuries to the Brachial Plexus

Samardžić, Miroslav; Rasulić, Lukas; Grujičić, Danica

doi:10.1097/00005373-199710000-00014

Cited by 27 publications

(28 citation statements)

References 3 publications

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“…Bullets may cause direct damage to the nerve or indirect injury with cavitation effect. [18] The incidence and the etiological spectrum of PNIs reflects the country's development level. In developed countries, MVA is the most common etiological factor.…”

Section: Discussionmentioning

confidence: 99%

“…Gunshot wounds to the plexus are of importance as they may be life-threatening and may lead to extremity loss in addition to causing permanent neurological deficit. [18,19] The major strength of our study is that it is one of the large series of PNIs in our country and reflects the the pattern of nerve injuries in the civilians. The limitations of this study are that it is a retrospective chart analysis and EMG evaluation was done by five different physicians over a period of eight years.…”

Section: Discussionmentioning

confidence: 99%

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Etiological factors of traumatic peripheral nerve injuries

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Etiological factors of traumatic peripheral nerve injuries

et al. 2009

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“…Highvelocity gunshot injuries damage the nerve elements through three different mechanisms: direct impact (rare), shock wave effects and cavitation effects. The latter two mechanisms provoke compression and stretching of the nerve 23 . These lesions are more intense and usually fail to recover spontaneously.…”

Section: Mechanisms Of Injurymentioning

confidence: 99%

Surgical treatment of adult traumatic brachial plexus injuries: an overview

Siqueira

Martins

2011

Arq. Neuro-Psiquiatr.

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Traumatic injuries to the brachial plexus in adults are severely debilitating. They generally affect young individuals. A thorough understanding of the anatomy, clinical evaluation, imaging and electrodiagnostic assessments, treatment options and proper timing of surgical interventions will enable nerve surgeons to offer optimal care to patients. Advances in microsurgical technique have improved the outcome for many of these patients. The treatment options offer patients with brachial plexus injuries the possibility of achieving elbow flexion, shoulder stability with limited abduction and the hope of limited but potentially useful hand function. Key words: brachial plexus injury, surgical treatment, nerve repair.Tratamento cirúrgico das lesões traumáticas do plexo braquial em adultos: uma visão geral RESUMO As lesões traumáticas do plexo braquial em adultos são severamente debilitantes e, em geral, afetam indivíduos jovens. Uma ampla compreensão da anatomia, da avaliação clínica, dos estudos eletrodiagnósticos e por imagem, das opções de tratamento e do momento apropriado para o tratamento cirúrgico irá permitir que o cirurgião de nervos ofereça o tratamento ideal ao paciente. Os avanços na técnica microcirúrgica melhoraram os resultados para muitos desses pacientes. As opções de tratamento oferecem aos pacientes com lesões do plexo braquial a possibilidade de obter flexão do cotovelo, estabilidade do ombro com abdução limitada e a esperança de função limitada mas potencialmente útil da mão. Palavras-chave: lesão do plexo braquial, tratamento cirúrgico, reparo de nervos. Traumatic brachial plexus lesions in adults are devastating injuries. The typical patient is a young man who was injured in a motorcycle accident. These lesions are of great social significance since most of the patients have to face severe residual morbidity after their injuries. The exact number of lesions occurring each year is difficult to ascertain, but it is certainly growing, in parallel with the increasing number of high-speed motor vehicle accidents, especially involving motorcycles.Based on experience with 1,068 patients with brachial plexus injuries, Narakas 1 developed a rule of "seven seventies" that gives an approximate idea of the statistics involved in brachial plexus lesions: approximately 70% of traumatic brachial plexus injuries are secondary to motor vehicle accidents; of these, approximately 70% involve motorcycles or bicycles. Of the cycle riders, approximately 70% have multiple injuries. Overall, 70% have supraclavicular lesions; of these, 70% have at least one root avulsion. At least 70% of patients with a root avulsion also have avulsions of the lower roots (C7, C8 or T1). Finally, of patients with lower root avulsion, nearly 70% will experience persistent pain.

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“…High-velocity injuries produce nerve damage by direct impact, shock waves and cavitation effects [1] . The initial injury dictates the outcome of nerve grafting [2] .…”

Section: Discussionmentioning

confidence: 99%

A Successful Case of Sural Nerve Cable Grafting after a Gunshot Wound to the Knees

Khanna

Mahajani²,

Proudman³

2005

Med Princ Pract

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Objective: To describe a successful case of sural nerve cable grafting to the leg following a gunshot injury. Clinical Presentation and Intervention: A 28-year-old man was shot at close range, sustaining extensive damage to the left popliteal fossa. Initial exploratory operation revealed a pierced sciatic nerve proximal to its bifurcation into the tibial and common peroneal branches. The 60% division 3.5-cm common peroneal deficit and the complete transection of the tibial division were repaired using an ipsilateral sural cable nerve graft that was not reversed. Initial re-assessment in the clinic setting revealed a denervation atrophy of all 3 leg compartments and paraesthesia below the left knee sparing the sural nerve. After 3 months, the patient had a significant improvement in both power and sensation which was felt to be due to a resolution of a neuropraxic component to the nerve injury. Re-assessment at 9 months and later at 14 months revealed an almost full recovery, suggestive of the success of the nerve grafting procedure. Conclusion: This report shows that, given favourable conditions, a good result is possible following use of cable nerve grafting to treat nerve damage from gunshot.

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Gunshot Injuries to the Brachial Plexus

Abstract: Compared with previous studies, the number of lesions with complete functional loss and complete anatomic loss of continuity is larger. In cases that were prognostically favorable according to the location of injury, the results are similar regardless of the type of nerve repair.

Cited by 27 publications

References 3 publications

Etiological factors of traumatic peripheral nerve injuries

Etiological factors of traumatic peripheral nerve injuries

Surgical treatment of adult traumatic brachial plexus injuries: an overview

A Successful Case of Sural Nerve Cable Grafting after a Gunshot Wound to the Knees

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