The Characteristic of 374 Surgically Treated Traumatic Brachial Plexus Injury Patients at an Indonesian Orthopedic Referral Hospital: An Epidemiologic and Sociodemographic View.

Abstract

Background: Traumatic brachial plexus injury (TBPI) is a severe injury in the upper extremity which can affect the quality of life. The incidence of these injuries has been increasing in recent years. The purpose of this study was to describe the characteristic of TBPI patients treated by surgery at a tertiary Orthopedic hospital in Surakarta, Indonesia.

Methods: This is a descriptive retrospective study of patients diagnosed with TBPI who underwent surgery between July 2013 and December 2021.

Results: This study included 374 patients with male predominance (86.10%) and an average age of 30.61 years. The most common age group was 20-29 years (45.45% of all age groups). Traffic accidents were the most common cause of this injury (91.98%), especially motorcycle accidents (94.48% of traffic accidents). The most frequent type was complete preganglionic complete injury (48.93%). Most of the patients were the result of traction injury (96.26%). The right side (58.02%) was more common. One patient (0.27%) presented with bilateral lesions. As much as 52.67% of patients presented with concomitant injuries. Fractures were the most common concomitant injuries (90.73%). Humeral shaft fractures were the most common fractures (29.10%), followed by forearm and clavicle fractures (16.10% and 21.98% respectively). A total of 19.52% of patients underwent surgery between 3 and 6 months after trauma. Nerve procedures were performed in 57.38% of all surgical procedures and the rest were secondary procedures: Tendon transfers (36.92%), arthrodesis (2.53%), and Free Functional Muscle Transfer (FFMT) 2.74%.

Conclusion: The young population, especially men, were commonly subjected to this injury with motorcycle accidents as the most common cause. Early recognition and optimum treatment must be done to improve functional outcomes. Improvement of road safety and spreading the health education of TBPI are recommended to reduce the incidence of injury and improve functional outcomes.