Kim Daniel H, Murovic Judith A, Tiel Robert L, Kline David G
Department of Neurosurgery, Stanford University Medical Center, CA 94305, USA.
J Reconstr Microsurg. 2006 Feb;22(2):67-72. doi: 10.1055/s-2006-932499.
This paper presents the management and outcomes for two consecutive operative series of gunshot wounds (GSWs) involving the brachial plexus. The cases were from Louisiana State University Health Sciences Center (LSUHSC) and were obtained by retrospective chart reviews. Series 1 includes patients with injuries managed between 1968 and 1980 and series 2, from 1981 to 1998. Pre- and postoperative motor function was assessed using the LSUHSC grading system. The outcomes for each surgical technique for each series are presented. Fewer cases of brachial plexus elements injured by GSWs in series 2 may be due to decreased firearm-related injuries between 1993-1997, i.e., 39,595 versus 32,436 deaths, respectively. The graft repair increase in series 2 may have been the result of more severe injuries, since documented trends between 1971 and 1997 show the use of larger caliber bullets. This paper shows that with the outlined management and surgical techniques, surgery on certain GSWs of the brachial plexus is worthwhile.
本文介绍了连续两个涉及臂丛神经枪伤（GSWs）手术系列的治疗及结果。这些病例来自路易斯安那州立大学健康科学中心（LSUHSC），通过回顾性病历审查获得。系列1包括1968年至1980年期间接受治疗的受伤患者，系列2包括1981年至1998年期间的患者。术前和术后运动功能采用LSUHSC分级系统进行评估。列出了每个系列中每种手术技术的结果。系列2中臂丛神经因枪伤而受损的病例较少，可能是由于1993 - 1997年间与枪支相关的伤害有所减少，即死亡人数分别为39,595人和32,436人。系列2中移植修复的增加可能是由于损伤更严重，因为1971年至1997年的记录趋势显示使用了更大口径的子弹。本文表明，采用所述的治疗和手术技术，对某些臂丛神经枪伤进行手术是值得的。
