J Reconstr Microsurg 2006; 22(2): 067-072
DOI: 10.1055/s-2006-932499
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Gunshot Wounds Involving the Brachial Plexus: Surgical Techniques and Outcomes

Daniel H. Kim1 , Judith A. Murovic1 , Robert L. Tiel2 , David G. Kline2
  • 1Department of Neurosurgery, Stanford University Medical Center, Stanford, CA
  • 2Department of Neurosurgery, Louisiana State University Medical Center, New Orleans, LA
Further Information

Publication History

Accepted: October 20, 2005

Publication Date:
03 February 2006 (online)

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ABSTRACT

This paper presents the management and outcomes for two consecutive operative series of gunshot wounds (GSWs) involving the brachial plexus. The cases were from Louisiana State University Health Sciences Center (LSUHSC) and were obtained by retrospective chart reviews. Series 1 includes patients with injuries managed between 1968 and 1980 and series 2, from 1981 to 1998. Pre- and postoperative motor function was assessed using the LSUHSC grading system. The outcomes for each surgical technique for each series are presented. Fewer cases of brachial plexus elements injured by GSWs in series 2 may be due to decreased firearm-related injuries between 1993-1997, i.e., 39,595 versus 32,436 deaths, respectively. The graft repair increase in series 2 may have been the result of more severe injuries, since documented trends between 1971 and 1997 show the use of larger caliber bullets. This paper shows that with the outlined management and surgical techniques, surgery on certain GSWs of the brachial plexus is worthwhile.

REFERENCES

Daniel H KimM.D. 

Department of Neurosurgery, Stanford University Medical Center

300 Pasteur Drive, Edwards Building, Room 201, Stanford, CA 94305-5327