Publication:

Surgical outcome of brachial plexus surgery: our experience

Background Brachial plexus injuries (BPIs) result in significant functional impairments, especially in developing countries like Bangladesh, where road traffic accidents are common. Advances in microsurgical techniques, such as nerve transfers and grafting, have improved outcomes. This study aims to evaluate the surgical outcomes of BPIs and contribute to optimizing treatment strategies for better recovery and functional restoration in patients with these complex injuries. To evaluate surgical outcomes, assess functional recovery and compare various surgical techniques for BPI management.

Methods This prospective observational study, conducted from May 2013 to March 2025, included 95 patients with post-traumatic BPIs from four major hospitals. Surgical interventions, including nerve transfers and grafting, were performed based on injury type. Preoperative and postoperative data were collected, including motor function assessment and patient rehabilitation outcomes, with follow-up at regular intervals for recovery monitoring.

Results The study included 95 patients with brachial plexus injuries, predominantly in the 18–30 age group (63.16%) and male (63.16%). The most common injury type was upper brachial plexus (42.1%), followed by global injuries (21.1%). Nerve transfers, especially Oberlin II, were the most performed surgery (31.6%). Postoperatively, 42.1% achieved good motor recovery (Grade 4), while 26.3% had excellent recovery (Grade 5). The follow-up ranged from 0–25+ months.

Conclusions Microsurgical techniques have improved brachial plexus injury management, but full upper limb function recovery remains suboptimal, especially in global injuries.