Vol. 3, Issue 10 (2014)

Author(s):
Kunjam VV Satyanarayana Dora and V Mallikarjun Rao

Abstract:
Background: Traumatic
brachial plexus injuries (TBPI) with concomitant fractures pose a complex surgical challenge. While early nerve repair is theoretically superior due to favorable biological conditions, the presence of skeletal trauma often delays intervention. This study compares the outcomes of primary versus delayed nerve repair in such cases.
Materials and Methods: A prospective comparative study was conducted at the Department of Surgery, Sree Balaji Medical College, Chennai, from October 2013 to September 2014. Forty patients with TBPI and associated fractures were enrolled and divided into two groups: Group A (primary repair within 6 weeks, N=20) and Group B (delayed repair after 12 weeks, N=20). Outcomes assessed included motor and sensory recovery, time to functional return, and complications. Statistical analysis was performed using t-tests and Chi-square tests with p<0.05 considered significant.
Results: Group A exhibited superior outcomes in motor recovery (MRC Grade 4-5 in 60% vs 30%; P=0.038), sensory recovery (S3-S4 in 80% vs 55%; P=.042), and earlier return to functional activity (mean 5.3 vs 8.7 months; P=0.001). Complication rates were higher in Group B but not statistically significant.