Relationship between disability and pain to post-traumatic stress disorder, depression, and anxiety in patient with postoperative brachial plexus injury (BPI)

Suroto, Heri; Putra, Ramadhan Ananditia; Karimah, Azimatul

doi:10.1080/02688697.2020.1784846

Cited by 11 publications

(11 citation statements)

References 20 publications

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“… 55 The literature has also reported that 24.39% of BPI patients were diagnosed with major depression and 7.3% with suicidal thoughts. 5 Likewise, our finding also found a significant pain (VAS) difference, favoring FFMT compared with nerve transfer. Chronic pain has been associated with reduced quality of life, interfering with physical functioning, professional and private life, sleep, and mood.…”

Section: Discussionsupporting

confidence: 66%

“…Brachial plexus injury (BPI) is one of the most devastating injuries affecting the upper limb, leading to functional impairment, physical disability, socioeconomic burden, and psychological disorders that mostly affects young man in their productive age. 1 2 3 4 5 A study from Kaiser et al stated that the most common cause of BPI cases is trauma, mainly from motorcycle accidents (67%). 6 There were 112,771,136 units of motorcycles registered in 2019 in Indonesia, making motorcycles the most common mode of transportation used (81.78%) in the country, with annual increment of 6.2%.…”

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confidence: 99%

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Traumatic Brachial Plexus Injury in Indonesia: An Experience from a Developing Country

Suroto

Antoni

Siyo

et al. 2021

J Reconstr Microsurg

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Background Brachial plexus injuries (BPI) cause severe physical disability and major psycho-socioeconomic burden. Although various countries have reported BPI incidence, the data from Indonesia as the fourth most populated country in the world remains unknown. We aim to assess the distribution of traumatic BPI, patients' characteristics, and treatment modalities in Indonesia. Methods A retrospective investigation was performed comprising 491 BPI patients at a tertiary referral hospital in Indonesia from January 2003 to October 2019. Demographic and outcomes data were retrieved from medical records. Results The average BPI patients' age was 27.3 ± 11.6 years old, with a male/female ratio of 4.6:1. Motorcycle accidents caused the majority (76.1%) of all BPI cases. Concomitant injuries were present in 62.3% of patients, dominated by fractures (57.1%) and brain injuries (25.4%). BPI lesion type was classified into complete (C5-T1, observed in 70% patients), upper (C5-C6, in 15% patients), extended upper (C5-C7, in 14% patients), and lower type (C8-T1, in 1% patients). The average time to surgery was 16.8 months (range 1–120 months), with the majority (76.6%) of the patients was operated on six months after the trauma. Free functional muscle transfer (FFMT) was the most common procedure performed (37%). We also analyzed the functional outcomes (active range of motion (AROM) and muscle power), DASH (Disabilities of the Arm, Shoulder, and Hand) score, and VAS (Visual Analogue Scale) across four most frequent procedures involving nerve reconstruction (FFMT, nerve transfer, external neurolysis, and nerve grafting). We found that FFMT was significantly better than nerve transfer in terms of DASH score and VAS (p = 0.000 and p = 0.016, respectively) in complete BPI (C5-T1). Moreover, we also found that nerve grafting resulted in a significantly better shoulder abduction AROM than nerve transfer and external neurolysis in extended upper BPI (C5-C7) (p = 0.033 and p = 0.033, respectively). Interestingly, no significant differences were observed in other measurements. Conclusion This study provides an overview of traumatic BPI patients in a single tertiary trauma center in Indonesia, expressing the profile of their characteristics and functional outcomes after surgical procedures.

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Section: Discussionsupporting

confidence: 66%

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confidence: 99%

Traumatic Brachial Plexus Injury in Indonesia: An Experience from a Developing Country

Suroto

Antoni

Siyo

et al. 2021

J Reconstr Microsurg

Self Cite

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“…Early evaluations to establish a temporary relationship between surgery and symptom improvement have the limitation of not being able to define the effect; this is because patients over-/under-estimate their symptom relief while they are healing during the first few days/weeks after surgery [ 18 ]. For this reason, the evaluation at the first postoperative week was not considered in the analysis.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic Pain Relief after Surgical Neurolysis in Patients with Traumatic Brachial Plexus Injuries: A Preliminary Report

Armas-Salazar

Téllez-León

García-Jerónimo

et al. 2022

Pain Research and Management

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Objective. To evaluate the usefulness of surgical neurolysis for neuropathic pain relief in patients with posttraumatic brachial plexus injury (BPI). Methods. A prospective, longitudinal, nonrandomized, self-controlled before and after study was performed to evaluate the pain changes according to their intensity using the Visual Analogue Scale (VAS), and the sensory recovery after surgery using the British Medical Research Council (BMRC) scale for sensory recovery. To establish significant changes, a paired T-test was performed, and in order to determine the magnitude of these changes, an effect size was measured. α = 0.05. Results. Ten patients were included with an average follow-up of 61.9 ± 53.62 months. The main mechanism of injury was vehicular trauma (70%). A significant decrease in pain after the surgical intervention was observed resulting from an average preoperative state according to VAS of 8.4 ± 1.58, to a postoperative state of 3.4 ± 3.27 (59.52%, p = 0.005, Δ = 1.572), added to a mean sensory improvement (25%) from 2.8 ± 1.62 to 3.5 ± 0.97 after surgery according to BMRC, without statistically significant changes ( p = 0.062 ), showing a moderate effect size (Δ = 0.413). Almost all patients showed improvement in the continuous and paroxysmal pattern of pain. No postoperative complications were observed. Discussion. These results suggest that in cases of BPI that originates from a compressive syndrome secondary to the posttraumatic fibrosis that surrounds the nerve structures causing strangulation and inducing hypernociception, the use of surgical neurolysis is an appropriate alternative for patients with medically refractory neuropathic pain.

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“…Clinical practice has shown that individuals with BPI tend to experience emotional and psychological changes due to pain, disruptions in daily activities, dependence on others, inability to work with jobs prior to the injury, uncertainty about the future, and appearance at work injured extremity. All of the consequences may lead to depression and more and more pain levels than without depression([ 29 , 30 ]).…”

Section: Discussionmentioning

confidence: 99%

Relationship between disability and pain to post-traumatic stress disorder, depression, and anxiety in patient with postoperative brachial plexus injury (BPI)

Cited by 11 publications

References 20 publications

Traumatic Brachial Plexus Injury in Indonesia: An Experience from a Developing Country

Traumatic Brachial Plexus Injury in Indonesia: An Experience from a Developing Country

Neuropathic Pain Relief after Surgical Neurolysis in Patients with Traumatic Brachial Plexus Injuries: A Preliminary Report

Clinical and functional outcome after different surgical approaches for brachial plexus injuries: Cohort study

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