The epidemiology of adult traumatic brachial plexus lesions in a large metropolis

Abstract

Adult traumatic brachial plexus lesions are devastating injuries. Their real incidence is difficult to ascertain, but are certainly growing due to the increasing number of high-speed motor-vehicle accidents, especially in big cities. Analysis of the epidemiological characteristics of patients with traumatic brachial plexus lesions in São Paulo, Brazil, the sixth largest city in the world. This was a retrospective analysis of the epidemiological characteristics of patients submitted to surgical treatment of traumatic brachial plexus lesions in the Peripheral Nerve Surgery Unit of the Department of Neurosurgery of the University of São Paulo Medical School. In the period from 2004 to 2012, 406 patients underwent surgery. There were 384 (94.6%) men and 22 (5.4%) women. In 45.9% the compromised plexus was the right and in 54.1%, the left. The average age was 28.38years. Among the causes, the most frequent was motorcycle accidents (79%). Most of the lesions were supraclavicular. In 46.1% of cases the lesions were complete, in 30.1% the lesions compromised C5/C6 roots, in 20.9% the C5/C6/C7 roots were lesioned and in 2.9% the lesion was in the lower roots, C8/T1. Among the associated lesions the most prevalent were head trauma, observed in 34.2% of the cases; lesions of long bones in 38.8%; clavicle fractures in 25.9%; and thoracic trauma in 12.9%. In a population of adult patients with brachial plexus lesions with surgical indication, most of them comprise young male adults involved in high-energy motorcycle accidents.