Brachial Plexus Injury and Pain: Incidence and the Effects of Surgical Reconstruction

SARANATRA WAIKAKUL, M.D.*, WARAPORN WAIKAKUL, M.D.**, SOMSRI PAUSAWASDI,M.D.**

Affiliation : * Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University. Bangkok 10700. ** Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400. Thailand.

AbstractA prospective study of pain after brachial plexus injury was carried out on 246 patients with at least 2 years follow-up. All of them had closed traction injury from motorcycle accidents. There were 16 females and 230 males aged from 16 to 44 years old. The patients' biodata, onset of pain, characteristics of pain and treatment were recorded. Changes in pain after conservative and operative treatment and the outcome of treatment were analysed. Two hundred and nineteen patients (89%) had significant pain and 182 patients (74%) had severe pain. Most of them had continuous pain with 2 to 20 peaks of severe pain per day. Crushing type of pain was the most common but mixed type of pain caused the most distress. Conservative treatment before surgery could relieve the pain in 39 patients ( 15.8% ). Surgical reconstruction could further relieve the pain in 176 patients (80.36% ). However, 21 patients (8.5%) still had severe pain. Improvement in sensory function had more effect on pain reduction than motor function.

Keywords : Brachial Plexus Injury, Pain, Incidence, Effects of Surgical Reconstruction

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