Study of Post-Surgical Improvement in Motor Power/Functional Status in Upper Limb in Traumatic Brachial Plexus Injuries

Aim: The present study aimed to evaluate the clinical characteristics and functional gain of the upper limb in patients who underwent surgical treatment after traumatic brachial plexus injuries along with psychosocial assessment of the patient undergoing treatment. Methods: Total 32 patients brachial plexus injuries fulfilling the inclusion and exclusion criteria were selected for the present study. Patients were assessed for motor, functional outcomes in preoperative period and then followed up on OPD basis, and 6 monthly basis. Primary outcome evaluation was done by motor outcome and secondary outcome evaluation included the functional and psychosocial outcome. Results: Mean age of the patients was 24.87 yrs. Good motor outcome was seen in 9 cases (28.12%), 5 cases of which had upper and middle trunk lesions whereas 4 cases had Pan brachial plexus injury. 18 (56.25%) cases in total had poor motor outcome score, most of which had (14) Pan brachial plexus injuries. Out of the 16 early presenters, 4 (25%) had excellent recovery, while 5 (31.25%) had good recovery. In late presenters, only 1 (6.25%) patient had excellent recovery, whereas 3 (18.75%) patients had good recovery. Wilcoxon signed ranks test showed a statistically significant change in preoperative and postoperative pain severity score (Z = -4.014, P <0.05). Statistically significant changes were observed in preoperative and postoperative DASH score, physical functioning score, emotional health problems score, vitality score, emotional well-being score, social functioning score, bodily pain score and general health score (Z = -4.936, P <0.05). Conclusion: The study shows that brachial plexus surgery can provide good motor results (43.75%) in some patients, but not in more than 50%. The overall improvement in functional life is significant, and even minimal relief like allaying neuralgic pain (68.75%) and nominal motor function can provide a psychological boost to a broken-down individual from traumatic brachial plexus injury, helping them regain lost confidence.