Lebensqualität bei posttraumatischen Paresen des Plexus brachialis im Erwachsenenalter

Zusammenfassung

Verletzungen des Plexus brachialis gehören zu den schwersten Verletzungen der oberen Extremität. Auch bei intensiver konservativer und operativer Therapie kommt es bei den Betroffenen häufig zu schweren Einschränkungen ihrer Lebensqualität. Diese Arbeit präsentiert die Ergebnisse einer re­trospektiven klinischen Studie zur Lebensqualität nach Verletzungen des Plexus brachialis. Von 38 im Beobachtungszeitraum behandelten Patienten, konnten 25 Patienten inkludiert werden und die Funktionseinschränkung der Extremität mittels DASH Score sowie die Lebensqualität mittels Fragebogen zur Lebenszufriedenheit, FLZ^m erhoben werden. Des Weiteren wurden demografische Daten, Verletzungsmechanismen und -muster sowie die berufliche Situation ermittelt. Die untersuchte Patientengruppe bestand zum überwiegenden Teil aus jungen Männern, die sich im Rahmen von Verkehrsunfällen, insbesondere im Rahmen von Motorradunfällen verletzt hatten. Die Ergebnisse des DASH Scores zeigen, dass Verletzungen Plexus brachialis zu den Verletzungen mit den größten Funktionseinschränkungen der oberen Extremität gehören. Die damit verbundenen Einschränkungen in den verschiedenen Bereichen der Lebensqualität betreffen neben dem Gesundheitsbereich insbesondere die Bereiche Partnerschaft, Familie und Freizeit. Ein weiterer starker Zusammenhang besteht zwischen Lebensqualität und der Möglichkeit ins Berufsleben zurückzukehren. Wir empfehlen die Verwendung des DASH Scores und des FLZ^m Fragebogens als Routineinstrumente zur Evaluation des Therapieerfolgs in der Behandlung von Verletzungen des Plexus brachialis.

Abstract

Brachial plexus lesions are among the most severe injuries of the upper extremity. Despite intensive conservative and surgical treatment efforts, patients frequently suffer from serious impairments in the quality of life. This contribution presents the results of a retrospective clinical survey on the quality of life after brachial plexus injuries. Out of 38 treated patients, 25 patients could be included in the study. The disability of arm, shoulder and hand was evaluated by the DASH score and the quality of life by the FLZ^m, a questionnaire on life satisfaction. In addition, demographic data, work situation and mechanism and type of injury were recorded. The examined patients were mainly young males who were injured in traffic, in particular motorcycle accidents. The DASH score analysis revealed that plexus injuries are among the most disabling injuries of the upper extremity. The associated restrictions in the different sections of the quality of life involve not only the health-related section but also partnership, family and leisure time activities. A strong relation between the possibility to return to work and the quality of life was found. We recommend the use of the DASH score and the FLZ^m questionnaire on life satisfaction as routine tools for the evaluation of the therapeutic outcome after brachial plexus injuries.

Schlüsselwörter

Plexuschirurgie beim ­Erwachsenen - Plexus brachialis - Chirurgie der peripheren Nerven - obere Extremität

Key words

plexus surgery in adults - brachial plexus - surgery of peripheral nerves - upper limb

^* Dr. Holdenried und Dr. Schenck haben zu gleichen Teilen zu dieser Arbeit beigetragen und teilen sich daher die Erstautorenschaft.

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