Evaluation of nerve procedures and FFMT in adult BPI - the Surabaya experience

Purpose

The purpose of this study was to describe our experience with various nerve and muscle procedures in traumatic adult brachial plexus injuries.

Materials and methods

Two hundred and nine (n=209) cases of adult brachial plexus injuries were treated in Surabaya from March 2005 to May 2014. Thirty seven cases treated in 2014 were excluded from this study.

Results

The number of operative cases of brachial plexus injury increase each year. Fifty nine percent of cases were managed in public hospitals and 41% in private hospitals. Most of the patients were males (86%) and the rest were females (14%). Brachial plexus injury was most prevalent between 21-30 years of age (37%). Motor vehicle accident was the most frequent mode of injury (90%). The right side was the most frequently affected side (77%). The levels of injury were as follows: C5-6 postganglionic (24%), C5-7 postganglionic (19%), C8-T1 postganglionic (3%), C5-T1 (54%). In complete BPI, the combination of C5-7 postganglionic and C8-T1 preganglionic were present in 33% of cases. There were 2 types of surgical intervention: nerve procedure (67%) and muscle procedure (33%). Nerve transfer was the most frequently employed mode of nerve procedures (54%, one third of which was either Oberlin’s transfer or double fascicular nerve transfer). The most frequently performed muscle procedure was the free functioning muscle transfer (78%).