Pattern of peripheral traumatic neuropathy of the upper limb in Lagos

Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

“…Complementary a previous registry based study revealed higher rates of PNI in upper compared to lower extremity fractures [ 6 ]. Like prior series already stated we also observed a striking coincidence of PNI and vascular lesions which may be caused by the close anatomical proximity of arterial, venous and neural structures in the extremities [ 11 , 13 , 19 – 21 ]. Despite of equivalent average trauma load in both groups in terms of ISS and mean ICU period we noticed a distinctively increased length of mean hospital stay for PNI compared to control patients which caused considerable additional direct treatment expenditures measured with the cost estimator which has been implemented for the TR-DGU by Lefering et al [ 10 ].…”

“…An assessment of severely injured multiple trauma victims (ISS > =16) stated that patients without extremity injuries were on average about five years older than their counterparts with limb involvement [ 2 ] which suggests PNI cases comprising an even younger subgroup of an already young trauma population. Several case series of patients with brachial plexopathy, single or combined upper limb nerve trauma support the aforementioned epidemiological observations [ 11 – 13 ]. According to our observations upper extremity trauma with and without PNI can be separated basically by different typical etiological categories.…”

“…Corresponding to our results Asplund et al report on traffic accidents as most important cause of PNI and amputations in Sweden with brachial plexus injury being commonly induced by motorcycle accidents [ 17 ], but there are inconsistent findings concerning PNI etiology within the literature. On the one hand traumatic brachial plexopathies were induced by car and motorcycle accidents in 42% of cases in one study [ 12 ], but on the other hand there are also series reporting a significant fraction of traumatic nerve lesions being provoked by glass injuries [ 11 ] or stab wounds [ 7 ] highlighting the importance of the economic and regulatory context of the different study settings. A cut was the main cause of injury in a series of 45 patients suffering from severe hand trauma with about one third of this cohort showing major nerve involvement [ 18 ].…”

Peripheral nerve injuries: A retrospective survey of 456 cases

“…In spite of population differences, the literature is consistent in reporting a higher incidence of PNIs of the upper limbs,2, 10 although the most frequently affected nerves in earlier reports were the ulnar,1 radial,10 or digital9 nerves. For the lower limbs the most frequently affected nerves are reportedly the peroneal10 or sciatic nerves 9.…”

“…For the lower limbs the most frequently affected nerves are reportedly the peroneal10 or sciatic nerves 9. Men were more frequently involved, in as much as 96%,2 83%,10 80%,1 and 74.2%9 of cases. In the different reported series, the most common trauma category was variable; penetrating trauma was responsible for 89.4% in one series,9 gun‐shots for 83.9% in another,2 and motor vehicle accidents for 46% in a third series 10.…”