Clinical Analysis Of Segmental Brachial Plexus Injury

Objective:In order to explore the diagnosis and treatment of segmental brachial plexus injury and provide a reliable reference for the future on such damage in clinical practice, we studied through case observe, understand and summarize the mechanism segmental brachial plexus injury, combined with the results of intraoperative nerve exploration.Methods:We observed our hospital clinical data of surgical treatment of brachial plexus injury from October 2012 to January 2015,52 patients who suffered multi-segmental brachial plexus injury and their follow-up were screened in order to obtain follow-up of 24 patients for the study, recording gender, injured side, age, occupation, education level, associated injuries, injury site, surgical and postoperative efficacy and analyzed.Results:There are 238patients in our hospital suffered brachial plexus injury from October 2012 to January 2015, including 52 patients segmental brachial plexus injury, the overall incidence rate was 21.9%(52/238). Which were followed by 24 cases, two segments of 91.7 injury patients (22/24), three segmental damage of 8.3%(2/24). Time from injury to first operation is 7 days to 7 months, average 2.43 ± 2.15 months, at least six months or more to get follow-up of patients with 18 cases, patients were followed up for 2 to 24 months, average 19.04 ± 14.83 months. The group segmental brachial plexus injury were 24 cases:1 male to female ratio of 7:1, with an average age of 25.06 ± 13.01 years; 2 occupations workers (migrant workers) amounted to 58.3%(14/24), unemployed up.25%(6/24); 3. Injury causes belt stretch injury of 58.3%(14/24), followed by up to 20.8 percent of motorcycle injury (5/24); 4. The combined total of the group of wounded patients 83.3%(14/24), ipsilateral limb fracture of 62.5%(10/24), with brain injury and up to 20.8%(5/24), with vascular muscle damage up to 16.7%(4/24) and organ damage 12.5%(3/24); 5. blunt trauma in this group reached 87.5%(21/24),12.5%open injury (3/24), the clavicle injury roots cadres of 20.8%(5/24), subclavian bundle branch damage of 79.2%(19/24), arm injury branch portion of 91.6%(22/24), forearm injury branch portion of 16.7%(4/24); 6 surgical procedures and prognosis:The patients of the total strength of 55.7%over M3, which neurolysis good rate of up to 70.8 percent, followed by nerve transfer up to 44.4%, nerve graft, multiple nerve transposition is poor, respectively,40.0% and 42.9%.Conclusion:More specific mechanism of injury showed in segmental brachial plexus injury than others, and it’s difficult to locate the damages.