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Home > Archives > Volume 20, No 7 (2022) > Article

DOI: 10.14704/nq.2022.20.7.NQ33352

Clinical and Functional Evaluation of Nerve Transfer in Patients with Traumatic Brachial Plexus Injury

Muhammad Abdurrahman Al Haraani, Heri Suroto, Lydia Arfianti

Abstract

Background : Traumatic Brachial Plexus Injury (TBPI) is an injury to the peripheral nerves in the neck and shoulder area, which lead to the paralysis of the shoulder, elbow, wrist, and fingers muscles. The previous investigation showed that TBPI affects va rious aspects of a patient's life such as the permanent loss of function in daily activities and work. The reconstruction of the nerve on the brachial plexus is to restore clinical function and achieve optimal quality of life. Therefore, this study aims to evaluate the relationship between the time to surgery and the clinical as well as the functional outcomes of patients with TBPI after nerve transfer surgery . Case : An analytical observational study with a retrospective cohort design was conducted. The da ta were taken from all TBPI patients who had passed through nerve transfer surgery by a surgeon (HSO) at the Soetomo General Academic Hospital between January 2009 and December 2019. After meeting the inclusion and exclusion criteria, pre and postoperativ e data DASH, VAS, SF36, shoulder range of motion (ROM), elbow and wrist ROM, as well as the sensory function of sample patients were recorded and tabulated. The data obtained were analyzed for distribution normality and the significance was tested using a T test or Mann Whitney Result : A total of 50 TBPI patients who are mostly adults (n=25, 50%), male (n=45, 90%) was evaluated. Based on the comparison between pre and post operative scores in patients who were operated on <6 months versus >6 months after injury, significant improvements were discovered in <6 months operation on almost all metrics. These include DASH, VAS, SF36, Shoulder Strength and ROM, Elbow strength and ROM, as well as wrist strength and ROM, except for sensory values, namely <6 months and >6 month with hypoesthesia which were 66.67%, and 73.7%, respectively, with p=0.23. Conclusion : Shorter delay between injury and surgery in TBPI patients improved pain outcome, quality of life, and arm function

Keywords

Brachial Plexus Injury, Nerve Transfer, Clinical Evaluation

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