Department of Orthopedic Trauma and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
Acta Neurochir (Wien). 2019 May;161(5):899-906. doi: 10.1007/s00701-019-03871-y. Epub 2019 Mar 15.
Traumatic brachial plexus injuries are severe lesions, and the incidence of these injuries has been increasing in recent years.
The clinical data of 510 operated patients with brachial plexus injury recruited from 74 hospitals in Guangxi from 2004 to 2016 were retrospectively studied.
Our study included 447 males and 63 females, with an average age of 29.04 years. Traffic accidents were the most common cause of injury (64.71%), especially motorcycle accidents. Closed injuries accounted for 88.24% of cases, and 83.53% of patients had associated injuries, the most common of which were fractures (76.27%). The preoperative predictive value of root injury of MRI and CT was 74.71% and 71.28%, respectively. 44.71% of patients underwent an initial operation within 6 months after the trauma. Regarding the surgery, neurolysis alone, brachial plexus reconstruction, and free functioning gracilis graft accounted for 16.67%, 75.50%, and 4.51%, respectively. A total of 415 patients were followed up with an average time of 47.95 (25-68) months, and anxiety or depression were found among 81.20% of them. Two hundred seventy-six patients suffered from nerve pain, with mild pain present in 67.03% of patients. Additionally, 347 patients were followed up for more than 3 years, 76.81% of patients with C5-C6 injury recovery to useful function, and the procedure of neurolysis alone demonstrated the best efficacy (79.45%).
Brachial plexus injury is still a challenging trauma for surgeons, and traffic accidents are the dominant cause. Timely and effective surgery is important for functional limb recovery.
创伤性臂丛神经损伤是一种严重的损伤，近年来其发病率一直在上升。
回顾性分析 2004 年至 2016 年广西 74 家医院收治的 510 例臂丛神经损伤手术患者的临床资料。
本研究共纳入 447 例男性和 63 例女性患者，平均年龄为 29.04 岁。交通伤是最常见的损伤原因（64.71%），尤其是摩托车事故。闭合性损伤占 88.24%，83.53%的患者合并其他部位损伤，最常见的是骨折（76.27%）。MRI 和 CT 对神经根损伤的术前预测价值分别为 74.71%和 71.28%。44.71%的患者在创伤后 6 个月内接受初次手术。手术方式中，单纯神经松解术、臂丛神经重建术和游离股薄肌移植术分别占 16.67%、75.50%和 4.51%。共 415 例患者获得平均 47.95（25-68）个月的随访，其中 81.20%的患者存在焦虑或抑郁。276 例患者存在神经痛，其中 67.03%的患者疼痛轻微。此外，347 例患者随访时间超过 3 年，C5-C6 损伤患者中 76.81%恢复到有用功能，单纯神经松解术的疗效最好（79.45%）。
臂丛神经损伤仍然是外科医生面临的挑战，交通伤是主要原因。及时有效的手术对肢体功能恢复至关重要。
