Distribution and extent of involvement in brachial plexopathies caused by gunshot wounds, motor vehicle crashes, and other etiologies: A 10-year electromyography study

Abstract

Bowles AO, Graves DE, Chiou-Tan FY. Distribution and extent of involvement in brachial plexopathies caused by gunshot wounds, motor vehicle crashes, and other etiologies: a 10-year electromyography study. Arch Phys Med Rehabil 2004;85:1708–10. Objective To examine the differences in the extent and distribution of brachial plexopathy involvement caused by gunshot wounds (GSW), motor vehicle crashes (MVCs), and other etiologies, based on electrophysiologic data. Design Retrospective review of electrophysiologic data from 1993 to 2002. Setting A large urban county hospital. Participants Sequential patients (N=109) with the diagnosis of brachial plexopathy established by electromyography testing. This included 35 patients with GSW, 25 involved in an MVC, and 49 with other etiologies. Interventions Not applicable. Main Outcome Measures The brachial plexus was divided into 9 regions: upper, middle, and lower root; upper, middle, and lower trunks; and lateral, posterior, and medial cords. Regions involved by needle study on electromyography were denoted as positive or negative. The total number of regions involved was also recorded. Results Injury was most common in the trunks (52%), cords (36%), and roots (12%) (Pearson χ 2, P<.000). Specifically, the “other” category had the greatest number of injuries to the trunks (54%) (Pearson χ 2, P<.000), whereas the trunks (46%) and cords (45%) were more evenly affected in GSW cases (Pearson χ 2, P=.585). In the MVC group, there was a trend toward more trunks (56%) being affected (Pearson χ 2, P=.076). Conclusions Differences were noted in the distribution of injury when examining subtypes of traumatic brachial plexopathies.