Health-related quality of life and functional outcomes following nerve transfers for traumatic upper brachial plexus injuries

J Hand Surg Eur Vol. 2012 Sep;37(7):642-51. doi: 10.1177/1753193411432706. Epub 2011 Dec 16.

Abstract

We report the patient-scored Health-Related Quality of Life (HRQoL) and functional outcomes of a cohort of 21 consecutive patients undergoing nerve transfer surgery for traumatic upper brachial plexus injuries. Outcomes were assessed using the British Medical Research Council power grading system, Short-Form 36, Disability of Arm, Shoulder and Hand questionnaire, and Pain Visual Analogue Scale (PVAS). The mean age of our cohort was 29.8 years (range 18-53 years), with a mean follow-up period of 42.9 months. At follow-up, elbow flexion ≥ M3 strength was achieved in 17/21 patients. Shoulder abduction ≥ M3 was achieved in 14/19 patients. External rotation ≥ M3 strength was achieved in 11/15 patients. Delayed surgical repair correlated negatively with HRQoL outcomes. Higher injury severity scores and smoking were associated with higher PVAS scores. These findings provide key prognostic information for patients and peripheral nerve surgeons embarking upon this intensive pathway to potential recovery.

MeSH terms

  • Adolescent
  • Adult
  • Arm Injuries / surgery*
  • Brachial Plexus Neuropathies / surgery*
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Nerve Transfer / methods*
  • Pain Measurement
  • Prognosis
  • Quality of Life*
  • Recovery of Function*
  • Risk Factors
  • Surveys and Questionnaires
  • Treatment Outcome