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J Brachial Plex Peripher Nerve Inj 2009; 04(01): e66-e75
DOI: 10.1186/1749-7221-4-11
Research article
Secer et al; licensee BioMed Central Ltd.

Surgical outcomes of the brachial plexus lesions caused by gunshot wounds in adults[*]

Halil Ibrahim Secer
1   Department of Neurosurgery, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
,
Ilker Solmaz
1   Department of Neurosurgery, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
,
Ihsan Anik
2   Department of Neurosurgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
,
Yusuf Izci
1   Department of Neurosurgery, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
,
Bulent Duz
1   Department of Neurosurgery, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
,
Mehmet Kadri Daneyemez
1   Department of Neurosurgery, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
,
Engin Gonul
1   Department of Neurosurgery, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
› Author Affiliations
Subject Editor:
Further Information

Publication History

11 March 2009

23 July 2009

Publication Date:
18 September 2014 (online)

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Abstract

Background The management of brachial plexus injuries due to gunshot wounds is a surgical challenge. Better surgical strategies based on clinical and electrophysiological patterns are needed. The aim of this study is to clarify the factors which may influence the surgical technique and outcome of the brachial plexus lesions caused by gunshot injuries.

Methods Two hundred and sixty five patients who had brachial plexus lesions caused by gunshot injuries were included in this study. All of them were male with a mean age of 22 years. Twenty-three patients were improved with conservative treatment while the others underwent surgical treatment. The patients were classified and managed according to the locations, clinical and electrophysiological findings, and coexisting lesions.

Results The wounding agent was shrapnel in 106 patients and bullet in 159 patients. Surgical procedures were performed from 6 weeks to 10 months after the injury. The majority of the lesions were repaired within 4 months were improved successfully. Good results were obtained in upper trunk and lateral cord lesions. The outcome was satisfactory if the nerve was intact and only compressed by fibrosis or the nerve was in-contunuity with neuroma or fibrosis.

Conclusion Appropriate surgical techniques help the recovery from the lesions, especially in patients with complete functional loss. Intraoperative nerve status and the type of surgery significantly affect the final clinical outcome of the patients.

*This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


 

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