Abstract
In spite of the progress made by microneurosurgery, the treatment of brachial plexus injuries still remains a great challenge.
This personal series of 49 patients with brachial plexus injuries (excluding tumours and thoracic outlet syndromes) is peculiar because the cases arose after the introduction in Italy of the law requiring all motorcyclists to wear a safety helmet.
Our experience confirms that there has been a 32% increase in very severe almost irreparable injuries of the plexus in comparison with previous data reported in the literature.
This is probably due to the higher rate of survival among severely-injured patients, although the possibility of a direct effect of the helmet on the plexus cannot be completely discarded.
Our results confirm the good prognosis of the microsurgical repair of C5–C6 stretch injuries and infraclavicular lesions.
Sommario
Nonostante i progressi della microneurochirurgia, il trattamento delle lesioni del plesso brachiale rimane difficile. Gli Autori presentano una casistica di 49 pazienti portatori di lesione del plesso brachiale (esclusi i tumori e le sindromi dell'egresso toracico) interamente ottenuta dopo l'introduzione obbligatoria del casco protettivo per i motociclisti.
La nostra esperienza ha confermato un aumento delle lesioni considerate al limite delle possibilità chirurgiche (32%), rispetto alle casistiche preesistenti. Ciò è probabilmente dovuto alla sopravvivenza di pazienti gravemente traumatizzati che un tempo decedevano senza che una eventuale lesione del plesso potesse essere trattata, anche se non va trascurata la possibilità di un danno diretto del casco che comprima e trazioni il plesso brachiale durante la caduta. Per ciò che concerne i risultati del trattamento chirurgico gli Autori confermano la migliore prognosi delle lesioni da stiramento di C5–C6 e delle lesioni a sede infraclavicolare.
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Ferraresi, S., Garozzo, D., Griffini, C. et al. Brachial plexus injuries Guidelines for management: Our experience. Ital J Neuro Sci 15, 273–284 (1994). https://doi.org/10.1007/BF02339237
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DOI: https://doi.org/10.1007/BF02339237