Traumatic paralysis of the brachial plexus is an extremely disabling pathology. The type of trauma most frequently suffered by this group of patients is due to motorcycle injuries. It therefore affects a population of young patients. In the majority of cases, these patients receive compensation for permanent damage from insurance companies. Surgery of the brachial plexus enables various forms of functional recovery, depending on the number of roots of the brachial plexus involved in the injury. The aim of this study is to compare the functional deficit and the extent of the related compensation before and after surgical intervention, and to evaluate the saving in economic terms (understood as the cost of compensation paid by insurance companies) obtainable through surgical intervention. The authors analysed the functional recovery obtained through surgery in 134 patients divided into 4 groups on the basis of the number of injured roots. The levels of compensation payable to the patient before surgical intervention, and 3 years after, were then compared. The results showed that the saving obtainable through surgical treatment of brachial plexus injuries may exceed 65% of the economic value of the compensation that would have been attributable to the same patients if they had not undergone surgical treatment.
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http://dx.doi.org/10.1055/s-0033-1361098 | DOI Listing |
JBJS Case Connect
January 2025
Department of Orthopedic Surgery, Albany Medical Center, Albany, New York.
Case: We present the case of a 24-year-old woman who sustained a left midshaft clavicle fracture with acute subclavian artery compression, subclavian vein laceration, and complete brachial plexus palsy after a motor vehicle collision. The patient underwent urgent open reduction internal fixation of the clavicle and repair of the subclavian vein. Two years later, she underwent opponensplasty and flexor digitorum profundus tendon transfers.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany.
Case: We describe a 13-year-old adolescent girl experiencing persistent pain and reduced grip strength following nonoperative treatment of a medial epicondyle fracture-dislocation with closed reduction over 5 years before her referral to our clinic. Neurological examination and magnetic resonance imaging of the elbow revealed damage to the median nerve due to an entrapment within the elbow. Surgical release of the nerve resulted in complete pain relief and improved neurological function with normalized nerve conduction.
View Article and Find Full Text PDFFuture Sci OA
December 2025
Faculty of Medical Sciences, Obstetrics and Gynecology at Lebanese University, Beirut, Lebanon.
Background: Shoulder dystocia, a challenging condition for obstetricians, poses significant risks to both maternal and neonatal health, including maternal postpartum hemorrhage, neonatal hypoxia, and brachial plexus injury. Despite being unpredictable and unpreventable, effective management can mitigate these risks. Miscommunication and poor leadership are responsible for 72% of medical errors, which further highlights the importance of robust leadership skills in obstetric emergencies.
View Article and Find Full Text PDFJ Brachial Plex Peripher Nerve Inj
January 2025
School of Health Sciences, Manchester Academic Health Science Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
GABA (γ-aminobutyric acid) is the major inhibitory neurotransmitter in the brain. In response to injury within the central nervous system, GABA promotes cortical plasticity and represents a potential pharmacological target to improve functional recovery. However, it is unclear how GABA changes in the brain after traumatic brachial plexus injuries (tBPIs) which represents the rationale for this pilot study.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Shriners Children's Northern California, Sacramento, California.
Background: Magnetic resonance imaging (MRI) has not been routinely used for infants with brachial plexus birth injury (BPBI); instead, the decision to operate is based on the trajectory of clinical recovery by 6 months of age. The aim of this study was to develop an MRI protocol that can be performed without sedation or contrast in order to identify infants who would benefit from surgery at an earlier age than the age at which that decision could be made clinically.
Methods: This prospective multicenter NAPTIME (Non-Anesthetized Plexus Technique for Infant MRI Evaluation) study included infants aged 28 to 120 days with BPBI from 3 tertiary care centers.
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