Sampath Kumar, S (2011) Outcome Analysis of Upper Brachial Plexus Injury at Govt. Stanley Hospital. Masters thesis, Madras Medical College, Chennai.
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Abstract
AIM OF THE STUDY: I. Demographic analysis of brachial plexus injury regarding 1. Age, 2. Gender, 3. Various Levels of Injury, 4. Side of Injury, 5. Mode of Injury, 6. Occupation, 7. Association Injuries and, 8. Comparative Study of Total B.P.I and upper B.P.I. II. To analyze the functional outcome of 20 upper brachial plexus injury patients out of 35 total brachial plexus injury cases assessed during the period of 4 months and followed up for nearly 10 months. MATERIALS AND METHODS: We have clinically assessed 35 patients of brachial plexus injury who presented at the Institute of Hand and Reconstructive Microsurgery and Department of Plastic Surgery from 1.5.2010 to 30.9.2010 and were followed for nearly 10 months. Assessment of each patient made and recording made in the proforma shown in subsequent pages. After the history recording Inspection finding recorded and main examination is to exclude the involvement of root. Examination of suprascapular muscle and Rhomboides muscle are important. How to examine the muscle demonstrated in the picture. We can see the contraction of Rhomboidus Muscle on adduction of scapula and we need to palpate the contraction of the muscle adduction of scapula against resistance. Same way Latismus dorsi muscle also seen contracting on coughing we need to palpate contraction of the muscle when shoulder is extended and adducted against resistance. Pectoralis major is having clavicular and sternal origin should be examined individually and recorded. CONCLUSION: The study revealed that the productive age group of 21 to 30 years was commonly injured with brachial plexus injury. It was the males who were mostly involved. Total brachial plexus injury formed a large chunk of the patients with brachial plexus injuries, but the second commonest involvement was the upper trunk lesion of C5,6 or C5,6,7. It was commonly the right side that was involved and thus involved the dominant hand. Road traffic accidents with two wheelers formed the majority of cases with brachial plexus injuries. The occupation of the patient did not show any significant difference whether student, manual labourer of sedentary labourer was concerned. The demographic pattern of injuries of brachial plexus was almost similar when the total plexus injury and the upper plexus injury were concerned, except in the presence of associated injuries, where, upper lesions appeared to have more percentage of associated injuries. Outcome analysis revealed good results in surgical treatment of upper brachial plexus lesions, except in the Oberlin procedure of nerve transfer where the results were comparatively poorer. Management of the patient is difficult pre and post operatively. A correct evaluation of the patient pre operatively, and planning and execution of the correct surgical procedure and post surgical rehabilitation are essential. Nevertheless, with a highly motivated patient and a dedicated and specialized surgical team, the prognosis for functional recovery is good, especially in upper brachial plexus injuries, and these patients can still lead productive and satisfying lives. Education of public regarding speed control, obeying traffic rules should be done especially for college students for prevention of brachial plexus injuries, which is much easier than curing these problems.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Outcome Analysis ; Upper Brachial Plexus Injury. |
| Subjects: | MEDICAL > Physical Medicine and Rehabilitation |
| Depositing User: | Kambaraman B |
| Date Deposited: | 09 May 2018 03:21 |
| Last Modified: | 09 May 2018 03:21 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7674 |
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