Management and outcome of blunt traumatic brachial plexus injuries in adult trauma patients: A retrospective study

Table 2 Management and outcome of traumatic brachial plexus injury, n (%)/median (interquartile range)

Variables	Value	Variables	Value
Sunderland classification		Ventilator days	1 (1-18)
Fifth-degree injury	10 (27.8)	ICU length of stay	3.5 (1-36)
Third-degree injury	10 (27.8)	Hospital length of stay	10.5 (1-89)
First-degree injury	8 (22.2)	Mortality	0 (0.0)
Fourth-degree injury	5 (13.9)	BMRC scale (long-term outcome)
Second-degree injury	3 (8.3)	Motor scale
BMRC (after injury)		M0 no contraction	9 (25.0)
Motor scale		M1 flicker (trace of contraction)	3 (8.3)
M0 no contraction	9 (25.0)	M2 active movement with gravity eliminated	3 (8.3)
M1 flicker (trace of contraction)	3 (8.3)	M3 active movement against gravity	8 (22.2)
M2 active movement with gravity eliminated	4 (11.1)	M4 active movement against gravity and resistance	9 (25.0)
M3 active movement against gravity	10 (27.8)	M5 normal (full) power	4 (11.1)
M4 active movement against gravity and resistance	7 (19.4)	Sensory scale
M5 normal (full) power	3 (8.3)	S0 no sensation	5 (13.9)
Sensory scale		S1 pain sensation	0 (0.0)
S0 no sensation	5 (13.9)	S2 pain and some touch sensation	5 (13.9)
S1 pain sensation	1 (2.8)	S3 pain and touch with no overreaction	4 (11.1)
S2 pain and some touch sensation	5 (13.9)	S3+ some two-point discrimination	12 (33.3)
S3 pain and touch with no overreaction	8 (22.2)	S4 normal sensation	10 (27.8)
S3+ some two-point discrimination	16 (44.4)	Long-term outcome
S4 normal sensation	1 (2.8)	No recovery	24 (66.7)
Intubation	10 (27.8)	Some improvement	5 (13.9)
Exploratory laparotomy	1 (2.8)	Full recovery	7 (19.4)
ORIF	10 (27.8)	Follow-up duration (days)	1484 (8-5620)
Repair of blood vessels	6 (16.7)
Management
Conservative	32 (88.9)
Surgery1	4 (11.1)

¹Two patients had undergone modified Oberlin procedure, where the ulnar nerve fascicle was transferred to the brachialis muscles’ motor branch and the median nerve fascicle was transferred to the biceps motor branch. Another patient had also modified Oberlin procedure where fascicles of flexor carpi radialis and flexor carpi ulnar was utilized to restore elbow flexion. Additionally, trapezius muscle transfer to the deltoid was performed to restore shoulder abduction. One patient had the right spinal accessory nerve transferred to right suprascapular nerve to restore shoulder abduction function as the first stage. On the second stage, the intercostal nerve was transferred to the musculocutaneous nerve.

ORIF: Open reduction and internal fixation surgery; ICU: Intensive care unit; BMRC: British Medical Council Scale assessment.