Timing of surgery in traumatic brachial plexus injury: a systematic review

Journal of Neurosurgery
Enrico MartinMarike L D Broekman

Abstract

OBJECTIVEIdeal timeframes for operating on traumatic stretch and blunt brachial plexus injuries remain a topic of debate. Whereas on the one hand spontaneous recovery might occur, on the other hand, long delays are believed to result in poorer functional outcomes. The goal of this review is to assess the optimal timeframe for surgical intervention for traumatic brachial plexus injuries.METHODSA systematic search was performed in January 2017 in PubMed and Embase databases according to the PRISMA guidelines. Search terms related to "brachial plexus injury" and "timing" were used. Obstetric plexus palsies were excluded. Qualitative synthesis was performed on all studies. Timing of operation and motor outcome were collected from individual patient data. Patients were categorized into 5 delay groups (0-3, 3-6, 6-9, 9-12, and > 12 months). Median delays were calculated for Medical Research Council (MRC) muscle grade ≥ 3 and ≥ 4 recoveries.RESULTSForty-three studies were included after full-text screening. Most articles showed significantly better motor outcome with delays to surgery less than 6 months, with some studies specifying even shorter delays. Pain and quality of life scores were also significantly better with shorter delays...Continue Reading

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Citations

Sep 28, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Davi Jorge Fontoura SollaMario Gilberto Siqueira
Apr 3, 2021·The Journal of Hand Surgery·Dafang ZhangRohit Garg
Sep 2, 2021·Journal of Reconstructive Microsurgery·Heri SurotoBrigita De Vega

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