Chuan, Wong Chien
(2016)
Early review of shoulder arthrodesis in brachial plexus injury.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction:
Traumatic brachial plexus injury commonly occurs due to road traffic accident, it often leads to
long term devastating disability and psychological stress to the affected individual. The injury leads
to flail upper limb, impaired sensation and disabling pain. Shoulder arthrodesis is one of the
treatment options that improved upper extremities functional outcome. This study intended to
evaluate functional outcome of brachial plexus injury after shoulder fusion.
Methods:
A group of 22 patients with traumatic brachial plexus injury who undergone shoulder fusion from
January 2010 until December 2013 were selected. In the end 18 patients were included as study
subjects. All selected patients were evaluated for pain score, functional assessment using
Quick.DASH questionnaire, and General well-being using SF-36 questionnaire during recent clinic
follow up.
Results:
Shoulder fusion achieved significant reduction in pain among BPI patients . Most of the patient
(63.2%) experience moderate difficulty of upper limb function after evaluated with QuickDASH
questionnaire. All the patient achieved below average score in Physical Component Summary
(PCS) and only 3 (16.7%) patients achieved score average(> 50) in Mental Component Summary
(MCS). 16 (88.9%) patients achieved radiological union and only 2 (11.1%) patients had non-union.There were no significant correlation between radiological union and (QuickDASH) functional
outcome or (SF36v2) general well-being in this study. Although majority of patient's general health
(SF36v2) score below average, they were satisfied and had no regret to undergone shoulder fusion
surgery.
Conclusions:
Shoulder arthrodesis was able to reduce pain in BPI patients. Although majority of patient
experience moderate difficulty in upper limb functional score and below average general health
score. Most patients were satisfied with the surgery done. Shoulder arthrodesis helps stabilised the
shoulder joint which improved control of upper limb function and lead to better quality of life.
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