Outcomes for the shoulder and elbow following surgical reconstruction for traumatic brachial plexus injury in patients over 60 years

Abstract

This study aims to investigate surgical outcomes in elderly patients aged over 60 years old, with brachial plexus injury, undergoing nerve reconstruction using nerve grafts and/or nerve transfers for shoulder and elbow function. Twenty-two patients met the inclusion criteria. Postoperative median shoulder abduction was 35° in the single nerve transfer group (n = 12) and less than 20° in the single nerve grafting group (n = 2). Patients over 65 tended to have poorer outcomes. For elbow flexion strength, a higher proportion of patients in the nerve transfer group (11/12 cases) achieved M3 or greater elbow flexion compared with the nerve grafting group (3/7 cases). Elbow extension also improved in the reconstructive group (9/13 cases). Given these findings, elbow flexion reconstruction is the first priority, while shoulder abduction, showing poor results, should not consume excessive neurotizers. Elbow extension is the second priority, achievable through nerve reconstruction.

Level of evidence: IV