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.
