Yıl: 2013 Cilt: 19 Sayı: 6 Sayfa Aralığı: 521 - 528 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study

Öz:
AMAÇ: Bu çalışmanın amacı istatistiksel geçerliliği olan değerlendirme araçları kullanılarak fonksiyonel sonuçları ve hastaların yaşam kalitesini ince- lemektir. GEREÇ VE YÖNTEM: Hastalar telefon ile arandı. Kısa form-36 (SF-36), el-kol ve omuz maluliyet değerlendirme anketi (DASH), bir ağrı derecelen- dirme testi hastalar tarafından dolduruldu ve hastaların uygulanan cerrahi ile ilgili memnuniyeti sorgulandı. BULGULAR: İ.Ü. İstanbul Tıp Fakültesi, Nöroşirürji Kliniği’nde 1997-2010 yılları arasında travmatik brakiyal pleksus yaralanması (TBPY) tanısıyla toplam 33 hasta tek bir cerrah tarafından (MI) ameliyat edildi. Üç hasta değerlendirmeye katılmayı reddetti ve üç hasta çalışmaya alınmadı. Toplamda 27 hasta, ortalama 79.6 aylık takip süresi ile çalışmaya alındı. TBPY’nin en sık nedeni motorlu araç kazaları idi. On dört hastada izole supraklaviküler, üç hastada ise infraklaviküler yaralanma vardı. Kalan 10 hastada yaralanmalar hem supra- hem infraklavikülerdi. Üç hastada kök avülsiyonuna rastlandı. Travma sonrası ilk altı ay içinde ameliyat edilen hastaların SF-36, DASH testleri ve ağrı dereceleri, diğer hastalara göre belirgin şekilde daha iyi olarak bulundu. TARTIŞMA: SF-36 ve DASH gibi istatistiksel geçerliliği olan testler TBPY hastalarının değerlenmesinde kullanılabilecek değerli araçlardır. TBPY ile ilgilenen özelleşmiş merkezler için, bu testlerin ameliyat öncesi ve sonrası dönemde uygulanmasıyla hastaların öznel şikayetlerinin nesnel olarak değerlendirilmesi mümkündür.
Anahtar Kelime:

Konular: Cerrahi

Travmatik brakiyal plesus yaralanmaları cerrahisi sonrası fonksiyonel sonuçlar: Klinik çalışma

Öz:
BACKGROUND: The aim of this study is to evaluate functional outcome and quality of life using statistically validated tools. METHODS: Participating patients were called and asked questions from the Short Form 36 (SF-36), the Disability of the Arm, Shoul- der and Hand (DASH) questionnaire, a pain scale and an additional question on their satisfaction with surgery. RESULTS: A total of 33 patients were operated by a single surgeon (MI) between 1997 and 2010 at the Neurosurgery Department of Istanbul School of Medicine. Three of these patients refused to participate and three other patients were excluded, leaving 27 patients, with an average follow-up of 79,6 months, for review. The most common cause of traumatic brachial plexus injuries (TBPI) was motor vehicle accidents. Fourteen patients had isolated supraclavicular injuries and three patients had infraclavicular injuries. The remaining 10 patients’ injuries were both supra- and infraclavicular. Avulsion was encountered in three patients. The patients who were operated within the first six months after trauma represented significantly better scores in DASH, SF-36 and pain scale. CONCLUSION: Statistically validated tests like DASH and SF-36 questionnaires are valuable tools for evaluating TBPI patients. Centers specialized in treating TBPI with surgery may use these tests pre- and postoperatively which lead to objective personalized evaluation of patients’ subjective symptoms.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Kim DH, Cho YJ, Tiel RL, Kline DG. Outcomes of surgery in 1019 bra- chial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg 2003;98:1005-16.
  • 2. Ahmed-Labib M, Golan JD, Jacques L. Functional outcome of brachial plexus reconstruction after trauma. Neurosurgery 2007;61:1016-23.
  • 3. Ricardo M. Surgical treatment of brachial plexus injuries in adults. Int Orthop 2005;29:351-4.
  • 4. Millesi H. Surgical management of brachial plexus injuries. J Hand Surg Am 1977;2:367-78.
  • 5. Narakas A. Brachial plexus surgery. Orthop Clin North Am 1981;12:303- 23.
  • 6. Dubuisson AS, Kline DG. Brachial plexus injury: a survey of 100 con- secutive cases from a single service. Neurosurgery 2002;51:673-83.
  • 7. Kandenwein JA, Kretschmer T, Engelhardt M, Richter HP, Antoniadis G. Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases. J Neurosurg 2005;103:614-21.
  • 8. Kline DG, Tiel RL. Direct plexus repair by grafts supplemented by nerve transfers. Hand Clin 2005;21:55-69.
  • 9. Secer HI, Solmaz I, Anik I, Izci Y, Duz B, Daneyemez MK, et al. Surgi- cal outcomes of the brachial plexus lesions caused by gunshot wounds in adults. J Brachial Plex Peripher Nerve Inj 2009;4:11.
  • 10. Choi PD, Novak CB, Mackinnon SE, Kline DG. Quality of life and functional outcome following brachial plexus injury. J Hand Surg Am 1997;22:605-12.
  • 11. Kretschmer T, Ihle S, Antoniadis G, Seidel JA, Heinen C, Börm W, et al. Patient satisfaction and disability after brachial plexus surgery. Neurosur- gery 2009;65:189-96.
  • 12. Solway S, Beaton DE, McConnell S, Bombardier C. The DASH out- come measure user’s manual. 2nd ed. Toronto: Institute for Work & Health; 2002.
  • 13. Beaton DE, Davis AM, Hudak P, McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure: what do we know about it now? British Journal of Hand Therapy 2001;6:109-18.
  • 14. About the DASH. http://www.dash.iwh.on.ca/about.htm. Accessed February 25, 2006.
  • 15. McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32:40-66.
  • 16. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short- Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247-63.
  • 17. Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B. The American academy of orthopaedic surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg Am 2002;84-2:208-15.
  • 18. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health sur- vey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83.
  • 19. Birch R, Bonney G, Wynn Parry CB. Surgical disorders of the peripheral nerves. Edinburgh: Churchill Livingstone; 1998.
  • 20. Kline DG, Hudson AR. Nerve injuries: operative results for major nerve injuries, entrapments, and tumors. Philadelphia: W.B. Saunders; 1995.
  • 21. Leffert RD. Brachial plexus injuries. New York: Churchill Livingstone; 1985.
  • 22. Davis DH, Onofrio BM, MacCarty CS. Brachial plexus injuries. Mayo Clin Proc 1978;53:799-807.
  • 23. Kline DG, Judice DJ. Operative management of selected brachial plexus lesions. J Neurosurg 1983;58:631-49.
  • 24. Burchiel KJ, Ochoa JL. Surgical management of post-traumatic neuropathic pain. In: Burchiel KJ, editor. Neurosurgery Clinics of North America. Surgical Management of Peripheral Nerve Injury and Entrapment. Philadelphia: W.B. Saunders; 1991. p. 117-21.
  • 25. Jivan S, Kumar N, Wiberg M, Kay S. The influence of pre-surgical delay on functional outcome after reconstruction of brachial plexus injuries. J Plast Reconstr Aesthet Surg 2009;62:472-9.
  • 26. Norkus T, Norkus M, Pranckevicius S, Pamerneckas A, Zobakas A, Viz- girda A. Early and late reconstruction in brachial plexus palsy: a prelimi- nary report. Medicina (Kaunas) 2006;42:484-91.
  • 27. Flores LP. The importance of the preoperative clinical parameters and the intraoperative electrophysiological monitoring in brachial plexus surgery. Arq Neuropsiquiatr 2011;69:654-9.
  • 28. Bufalini C, Pescatori G. Posterior cervical electromyography in the di- agnosis and prognosis of brachial plexus injuries. J Bone Joint Surg Br 1969;51:627-31.
  • 29. Grant GA, Goodkin R, Kliot M. Evaluation and surgical management of peripheral nerve problems. Neurosurgery 1999;44:825-40.
  • 30. Midha R. Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 1997;40:1182-9.
  • 31. Magalon G, Bordeaux J, Legre R, Aubert JP. Emergency versus de- layed repair of severe brachial plexus injuries. Clin Orthop Relat Res 1988;237:32-5.
  • 32. Narakas AO. The treatment of brachial plexus injuries. Int Orthop 1985;9:29-36.
  • 33. Terzis JK, Papakonstantinou KC. The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg 2000;106:1097-1124.
  • 34. Samii M, Carvalho GA, Nikkhah G, Penkert G. Surgical reconstruction of the musculocutaneous nerve in traumatic brachial plexus injuries. J Neurosurg 1997;87:881-6.
  • 35. Kanaya F, Gonzalez M, Park CM, Kutz JE, Kleinert HE, Tsai TM. Im- provement in motor function after brachial plexus surgery. J Hand Surg Am 1990;15:30-6.
  • 36. McGillicuddy JE. Clinical decision making in brachial plexus injuries. Neurosurg Clin N Am 1991;2:137-50.
APA aras y, AYDOSELİ A, Sabancı P, AKÇAKAYA M, ALKIR G, İMER M (2013). Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. , 521 - 528.
Chicago aras yavuz,AYDOSELİ Aydın,Sabancı Pulat Akın,AKÇAKAYA MEHMET OSMAN,ALKIR Görkem,İMER Murat Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. (2013): 521 - 528.
MLA aras yavuz,AYDOSELİ Aydın,Sabancı Pulat Akın,AKÇAKAYA MEHMET OSMAN,ALKIR Görkem,İMER Murat Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. , 2013, ss.521 - 528.
AMA aras y,AYDOSELİ A,Sabancı P,AKÇAKAYA M,ALKIR G,İMER M Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. . 2013; 521 - 528.
Vancouver aras y,AYDOSELİ A,Sabancı P,AKÇAKAYA M,ALKIR G,İMER M Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. . 2013; 521 - 528.
IEEE aras y,AYDOSELİ A,Sabancı P,AKÇAKAYA M,ALKIR G,İMER M "Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study." , ss.521 - 528, 2013.
ISNAD aras, yavuz vd. "Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study". (2013), 521-528.
APA aras y, AYDOSELİ A, Sabancı P, AKÇAKAYA M, ALKIR G, İMER M (2013). Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. Ulusal Travma ve Acil Cerrahi Dergisi, 19(6), 521 - 528.
Chicago aras yavuz,AYDOSELİ Aydın,Sabancı Pulat Akın,AKÇAKAYA MEHMET OSMAN,ALKIR Görkem,İMER Murat Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. Ulusal Travma ve Acil Cerrahi Dergisi 19, no.6 (2013): 521 - 528.
MLA aras yavuz,AYDOSELİ Aydın,Sabancı Pulat Akın,AKÇAKAYA MEHMET OSMAN,ALKIR Görkem,İMER Murat Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. Ulusal Travma ve Acil Cerrahi Dergisi, vol.19, no.6, 2013, ss.521 - 528.
AMA aras y,AYDOSELİ A,Sabancı P,AKÇAKAYA M,ALKIR G,İMER M Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. Ulusal Travma ve Acil Cerrahi Dergisi. 2013; 19(6): 521 - 528.
Vancouver aras y,AYDOSELİ A,Sabancı P,AKÇAKAYA M,ALKIR G,İMER M Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study. Ulusal Travma ve Acil Cerrahi Dergisi. 2013; 19(6): 521 - 528.
IEEE aras y,AYDOSELİ A,Sabancı P,AKÇAKAYA M,ALKIR G,İMER M "Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study." Ulusal Travma ve Acil Cerrahi Dergisi, 19, ss.521 - 528, 2013.
ISNAD aras, yavuz vd. "Functional outcomes after treatment of traumatic brachial plexus injuries: Clinical study". Ulusal Travma ve Acil Cerrahi Dergisi 19/6 (2013), 521-528.