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Low Velocity Gun Shot Wounds of the Brachial Plexus

From the Department of Orthopaedic Surgery, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa

Correspondence: Dr R. S. Boome, Suite 217, Constantiaberg Medi-Clinic, Burnham Road, Plumstead 7800, Cape Town, Republic of South Africa.

28 patients with low velocity gunshot wounds of the brachial plexus were treated at Groote Schuur Hospital from 1980 to 1991. Delayed exploration of the brachial plexus (up to 7 months after injury) was performed in nine (30%) of the patients. The other 19 patients did not have exploration of the plexus; most of these patients showed signs of recovery within 2 to 4 weeks of injury. Injury to the subclavian or axillary artery occurred in nine (30%) of the cases.

The average length of follow-up of the patients was 19 months (range 2–90 months). Of the 19 patients treated non-operatively, 15 (79%) had an excellent or good result and four (21%) a fair result. The indications for surgery were the absence of improvement within 3 months of injury or persistent pain. Surgery was indicated for significant pain in five of the nine patients; post-operatively two had complete relief of pain, two improvement in the pain and one no improvement. Of the nine surgically treated patients, three (33%) had a good result, two (22%) a fair result and four (45%) a poor result. The potential for recovery was not dependent on the severity of the injury at presentation or the presence of vascular injury but on the appearance of signs of recovery within 4 weeks of injury.

Journal of Hand Surgery (British and European Volume), Vol. 20, No. 2, 212-214 (1995)
DOI: 10.1016/S0266-7681(05)80053-1


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