An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre

Abstract

Background:Epidemiological studies on traumatic brachial plexus injuries are few and these studies help us to improve the treatment, rehabilitation of these patients and to allocate the resources required in their management. Epidemiological factors can vary in different countries. We wanted to know the situation in an Indian centre.Materials and Methods:Data regarding age, sex, affected side, mode of injury, distribution of paralysis, associated injuries, pain at the time of presentation and the index procedure they underwent were collected from 304 patients. Additional data like the vehicle associated during the accident, speed of the vehicle during the accident, employment status and integration into the family were collected in 144 patients out of the 304 patients.Results:Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. Associated injuries like fractures, vascular injuries and head injuries are much less probably due to the lower velocity of the vehicles compared to the western world. The average time interval from the date of injury to exploration of the brachial plexus was 127 days and 124 (40.78%) patients presented to us within this duration. Fifty-seven per cent had joined back to work by an average of 8.6 months. It took an average of 6.8 months for the global brachial plexus-injured patients to write in their non-dominant hand.

High prevalence of neuropathic pain in the hand of patients with traumatic brachial plexus injury: a cross-sectional study

“…Quality of life was associated with pain in items related to pain and functional capacity domains. The characteristics of sex, age, type of accident and extent of injury were similar to other studies evaluating individuals with TBPI 6,7,8,10,17 . The majority of our patients had completed high school, but they were unemployed.…”

“…The prevalence of pain in these TBPI injuries is usually elevated 5,6,8,9,10 . Only one study found conflicting results 7 . As in our results, the pain usually begins suddenly and is located in the hand 1,11,19 .…”

“…Although some studies classify the pain present in TBPI according to well-established criteria 5,9 , many merely assume that pain is neuropathic given the presence of the brachial plexus injury 6,7 . Furthermore, most studies on pain in TBPI were not designed to describe the painful profile in this condition 7,8 .…”

“…Although some studies classify the pain present in TBPI according to well-established criteria 5,9 , many merely assume that pain is neuropathic given the presence of the brachial plexus injury 6,7 . Furthermore, most studies on pain in TBPI were not designed to describe the painful profile in this condition 7,8 . Giving the lack of detailed information about the pain profile in individuals with traumatic brachial plexus injury, this study had two objectives: a) to classify the type of pain as neuropathic or nociceptive; and b) to describe associations among pain characteristics, demographic data, quality of life, and symptoms of anxiety/depression.…”

“…Over 50% of individuals with TBPI experience pain 4,5,6,7,8,9,10 , which is generally described as shooting, smashing, burning or electric shocks 11,12 . The origin of the pain is not clearly established, and this may be a confounding factor for treatment.…”