Materiały źródłowe

• #1 Brachial plexus injury epidemiology [Neurosurgery Education Wiki]

  https://neurosurgery.education/wiki/doku.php?id=brachial_plexus_injury_epidemiology

  Epidemiological studies of traumatic brachial plexus injuries are few and most of them focus on treatment and prognosis. […] In a population of adult patients with brachial plexus lesions with surgical indication, most of them comprise young male adults involved in high-energy motorcycle accidents. […] Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. […] Brachial plexus injuries occur in 0.1% of pediatric multitrauma patients. Motor vehicle accidents and pedestrians struck by a motor vehicle are the most common reasons for BPIs in this population. […] Traction is the most frequent mechanism related to brachial plexus injuries, and root avulsions are common in these cases. […] In 1997 Midha published that Brachial plexus injury afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%.

• #1 Epidemiology of Adult Traumatic Brachial Plexus Injuries | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-69517-0_5

  Adult traumatic brachial plexus injuries (BPI) are devastating lesions that affect function and daily living activities and also have a substantial social, economic, and psychological impact, creating lifelong disabilities. […] Epidemiological studies of BPI are critical for addressing the magnitude of the problem and determining the characteristics of the affected individuals in order to create prevention plans and treatment. […] BPI are not common; the estimated annual incidence of BPI in the general population lies between 0.17/100,000/year and 1.6/100,000/year. […] Traumatic brachial plexus injuries occur more frequently in young male patients, and most are closed lesions caused by road traffic accidents (motorcycles) involving the supraclavicular plexus. […] Open lacerations and gunshot wounds are less common among civilian populations.

• #2 Epidemiology of brachial plexus injuries in a multitrauma population – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9179891/

  Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting to a regional trauma facility. […] Brachial plexus injuries afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%. […] Head injuries, thoracic injuries, and fractures and dislocations affecting the shoulder girdle and cervical spine are particularly common associated injuries.

• #3

  https://journals.lww.com/neurosurgery/fulltext/1997/06000/epidemiology_of_brachial_plexus_injuries_in_a.14.aspx

  Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting to a regional trauma facility. […] Brachial plexus injuries afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%.

• #4 ASPN – Epidemiology Of Brachial Plexus Injuries In A Multi-Trauma Population: A 10 Year Retrospective Analysis Of A Single Level I Trauma Center

  https://meeting.peripheralnerve.org/abstracts/2019/PNEP71.cgi

  Epidemiology Of Brachial Plexus Injuries In A Multi-Trauma Population: A 10 Year Retrospective Analysis Of A Single Level I Trauma Center […] The incidence and severity of traumatic brachial plexus injuries (BPI) in the US population is unknown. Canadian data estimates the incidence of traumatic BPI at 1.2% for all patients admitted to a regional trauma facility. […] One hundred fifty-nine subjects presented with brachial plexus injuries during this timeframe, representing 0.26% of all traumatic injuries. […] Our study represents the first large scale retrospective BPI review of a US based Level I trauma center, illustrating these injuries are rare, but more severe when associated with MVC.

• #5 Epidemiology of peripheral nerve and brachial plexus injuries in a trauma population | CJS

  https://www.canjsurg.ca/content/67/3/E261

  Understanding patterns of peripheral nerve injuries (PNIs) and brachial plexus injuries (BPIs) is essential to preventing and appropriately managing nerve injuries. […] The epidemiology of PNI and BPI in the trauma population remains minimally understood. […] Epidemiological studies from the 1990s found a prevalence of 2.8% for PNI and 1.2% for BPI in a trauma population from a tertiary trauma centre. […] Our study found a 1.6% prevalence of nerve injuries in a trauma population over the last 18 years (2002-2020), with a 1.3% prevalence of PNIs and a 0.3% prevalence of BPIs. […] Compared with previous studies at the same institution, which reported a prevalence of 2.8% for PNIs and 1.2% for BPIs, we found a decrease in nerve injuries. […] The longer time to diagnosis and increased use of diagnostic testing for patients with BPI may be associated with the high number of sharp injuries among patients with PNIs in our sample and may also highlight the difficulty in identifying BPIs in the acute trauma setting. […] Although the prevalence of nerve injuries within the trauma population has decreased in the last 3 decades, there have been shifts in mechanisms of injury, surgical treatments, and the use of electrodiagnostic tests for diagnosis.

• #6 SciELO Brazil – EPIDEMIOLOGICAL STUDY OF TRAUMATIC BRACHIAL PLEXUS INJURIES EPIDEMIOLOGICAL STUDY OF TRAUMATIC BRACHIAL PLEXUS INJURIES

  https://www.scielo.br/j/aob/a/D6zW8tysgSwJBycnVZpnMWG/

  Objective: To conduct an epidemiological study on brachial plexus injuries, through data collection of patients treated in the Hospital So Paulo, which is the referral center for high complexity in this region. […] We estimated an 1.88/100,000 annual incidence, considering that the Hospital is the only referral center for brachial plexus injuries. […] We observed many aspects in common with those reported by other centers of excellence in Brazil such as: sex, age and mechanism of injury. However, some findings were different from most other epidemiological studies, namely: level of injury, time between the accident and the first appointment and the time between injury and surgery. […] We found only three epidemiological studies on traumatic brachial plexus injuries in Brazil. […] We estimated an 1.88/100,000 annual incidence in ABC, considering that the Hospital Estadual Mario Covas is the only reference center for high complexity traumas, with 12.3 cases of traumatic brachial plexus injury per year.

• #7 EPIDEMIOLOGICAL STUDY OF TRAUMATIC BRACHIAL PLEXUS INJURIES – ScienceOpen

  https://www.scienceopen.com/document?vid=bfabe885-4f38-46c0-8331-cf5319026fe1

  EPIDEMIOLOGICAL STUDY OF TRAUMATIC BRACHIAL PLEXUS INJURIES Translated title: ESTUDO EPIDEMIOLÓGICO DAS LESÕES TRAUMÁTICAS DO PLEXO BRAQUIAL […] To conduct an epidemiological study on brachial plexus injuries, through data collection of patients treated in the Hospital São Paulo, which is the referral center for high complexity in this region. […] We estimated an 1.88/100,000 annual incidence, considering that the Hospital is the only referral center for brachial plexus injuries. […] We observed many aspects in common with those reported by other centers of excellence in Brazil such as: sex, age and mechanism of injury. However, some findings were different from most other epidemiological studies, namely: level of injury, time between the accident and the first appointment and the time between injury and surgery.

• #8 Epidemiology of peripheral nerve and brachial plexus injuries in a trauma population | CJS

  https://www.canjsurg.ca/content/67/3/E261

  Understanding patterns of peripheral nerve injuries (PNIs) and brachial plexus injuries (BPIs) is essential to preventing and appropriately managing nerve injuries. […] The epidemiology of PNI and BPI in the trauma population remains minimally understood. […] Epidemiological studies from the 1990s found a prevalence of 2.8% for PNI and 1.2% for BPI in a trauma population from a tertiary trauma centre. […] Our study found a 1.6% prevalence of nerve injuries in a trauma population over the last 18 years (2002-2020), with a 1.3% prevalence of PNIs and a 0.3% prevalence of BPIs. […] Compared with previous studies at the same institution, which reported a prevalence of 2.8% for PNIs and 1.2% for BPIs, we found a decrease in nerve injuries. […] The longer time to diagnosis and increased use of diagnostic testing for patients with BPI may be associated with the high number of sharp injuries among patients with PNIs in our sample and may also highlight the difficulty in identifying BPIs in the acute trauma setting. […] Although the prevalence of nerve injuries within the trauma population has decreased in the last 3 decades, there have been shifts in mechanisms of injury, surgical treatments, and the use of electrodiagnostic tests for diagnosis.

• #9 Brachial plexus injury – Wikipedia

  https://en.wikipedia.org/wiki/Brachial_plexus_injury

  Brachial plexus injury is found in both children and adults, but there is a difference between children and adults with BPI. […] The prevalence of brachial plexus injuries in North American adults in the 1900s was about 1.2%. Recent data from the UK suggests that the incidence is rising although the methods for capturing such data make computed incidence ratios unreliable. Traumatic BPI is most common in young healthy adults, aged 14 to 63 years old, with 50% of patients between 19 and 34 years old. The majority (89%) are male. […] OBPP, also known as obstetrical brachial plexus palsy, occurs primarily in young children at a rate of 0.38 to 1.56 per 1000 live births depending on the type of care and the average birth weight of infants in different regions of the world. […] BPI has shown to occur in 44% to 70% of traumatic injuries, such as motorcycle accidents, sporting activities, or workplace accidents.

• #10 SciELO Brazil – EPIDEMIOLOGICAL STUDY OF TRAUMATIC BRACHIAL PLEXUS INJURIES EPIDEMIOLOGICAL STUDY OF TRAUMATIC BRACHIAL PLEXUS INJURIES

  https://www.scielo.br/j/aob/a/D6zW8tysgSwJBycnVZpnMWG/

  The mean age of the patients affected was 26 years, ranging between 12 and 50 years, also consistent with the literature, in which most patients are young, making this injury even more devastating from the socio-economic point of view. […] In our study, the mean time between the trauma and the first appointment in the reference hospital was 8.25 months, ranging between 3 days and 15 months. […] Regarding the interval between injury and surgery, the mean of 11.25 months in our study was higher when compared with studies by Rocha et al. and Faglione et al. […] The percentage of total lesions was 33%, while upper and middle trunk injuries were 33% and 28%, respectively. […] We observed many aspects in common with those reported by other reference centers in Brazil after epidemiological analysis of the population with traumatic brachial plexus injury in the region (ABC metropolitan region), namely: sex, age and mechanism of injury. However, some findings were different from other epidemiological studies: level of injury, time between accident and first appointment and time between injury and surgical treatment.

• #11 Brachial plexus injury – Wikipedia

  https://en.wikipedia.org/wiki/Brachial_plexus_injury

  Brachial plexus injury is found in both children and adults, but there is a difference between children and adults with BPI. […] The prevalence of brachial plexus injuries in North American adults in the 1900s was about 1.2%. Recent data from the UK suggests that the incidence is rising although the methods for capturing such data make computed incidence ratios unreliable. Traumatic BPI is most common in young healthy adults, aged 14 to 63 years old, with 50% of patients between 19 and 34 years old. The majority (89%) are male. […] OBPP, also known as obstetrical brachial plexus palsy, occurs primarily in young children at a rate of 0.38 to 1.56 per 1000 live births depending on the type of care and the average birth weight of infants in different regions of the world. […] BPI has shown to occur in 44% to 70% of traumatic injuries, such as motorcycle accidents, sporting activities, or workplace accidents.

• #12

  https://link.springer.com/article/10.1007/s10143-018-1009-2

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 8797%), lacerations accounted for 3% (95% CI: 16%), and gunshot wounds (GSWs) for 3% (95% CI: 07%). The prevalence of male patients was 93% (95% CI: 9096%) and female cases 7% (95% CI: 410%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 4982%) prevalence followed by car crashes with 14% (95% CI: 820%). Other causes were rare. Ninety percent (95% CI: 7898%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 222%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 4758%) followed by upper plexus lesion with 39% (95% CI: 3148%) and lower plexus injury with 6% (95% CI: 112%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare. […] Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40:11821188 discussion 1188-1189. […] Goldie BS, Coates CJ (1992) Brachial plexus injury: a survey of incidence and referral pattern. J Hand Surg 17:8688.

• #13 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #14

  https://link.springer.com/article/10.1007/s10143-018-1009-2

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 8797%), lacerations accounted for 3% (95% CI: 16%), and gunshot wounds (GSWs) for 3% (95% CI: 07%). The prevalence of male patients was 93% (95% CI: 9096%) and female cases 7% (95% CI: 410%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 4982%) prevalence followed by car crashes with 14% (95% CI: 820%). Other causes were rare. Ninety percent (95% CI: 7898%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 222%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 4758%) followed by upper plexus lesion with 39% (95% CI: 3148%) and lower plexus injury with 6% (95% CI: 112%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare. […] Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40:11821188 discussion 1188-1189. […] Goldie BS, Coates CJ (1992) Brachial plexus injury: a survey of incidence and referral pattern. J Hand Surg 17:8688.

• #15 Traumatic Brachial Plexopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/316888-overview

  In general, traumatic brachial plexopathy is more prevalent in men than in women because of an association with violent trauma and sports. […] Because of an association with violent trauma and sports-related injuries, traumatic brachial plexopathy is most prevalent in males in their midteens and in men in their early 30s.

• #16 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #17

  https://link.springer.com/article/10.1007/s10143-018-1009-2

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 8797%), lacerations accounted for 3% (95% CI: 16%), and gunshot wounds (GSWs) for 3% (95% CI: 07%). The prevalence of male patients was 93% (95% CI: 9096%) and female cases 7% (95% CI: 410%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 4982%) prevalence followed by car crashes with 14% (95% CI: 820%). Other causes were rare. Ninety percent (95% CI: 7898%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 222%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 4758%) followed by upper plexus lesion with 39% (95% CI: 3148%) and lower plexus injury with 6% (95% CI: 112%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare. […] Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40:11821188 discussion 1188-1189. […] Goldie BS, Coates CJ (1992) Brachial plexus injury: a survey of incidence and referral pattern. J Hand Surg 17:8688.

• #18 Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

  https://www.mdpi.com/2411-5142/5/2/22

  Injuries of peripheral nerves can have a wide spectrum of etiology. […] Nevertheless, the involvement of brachial plexus structures due to these systemic and localized diseases is rare. Indeed, in the epidemiology of the etiology of isolated BPIs, traumatic events remain the main cause of injury. […] A closed lesion of the brachial plexus, mainly related to traction of peripheral nerves, represents 93% of traumatic BPIs. […] Motorcycle accidents are the main cause of traumatic BPIs, accounting for 67% of them. […] In occupational or sport activities, data from previous studies reported a pooled prevalence of 10% of traumatic BPIs. […] Some more detailed data about sport activities show an incidence of BPIs among nearly 4% of trauma related to winter sports. […] Obviously, BPIs are a common injury in contact sports but their exact incidence is difficult to estimate.

• #19 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #20

  https://www.orthobullets.com/trauma/1008/brachial-plexus-injuries

  Brachial plexus injuries (BPIs) can involve any degree of injury at any level of the plexus and range from obstetric injuries to traumatic avulsions. […] 75%-80% of traumatic BPIs are complete involvement of all roots. […] 20%-25% of traumatic BPIs involve C5 and C6 upper trunk (Erb palsy). […] 0.6%-3.0% of traumatic BPIs involve C8, T1 or lower (Klumpke palsy). […] 83% of traumatic BPIs are due to high speed vehicle accidents (mostly motorcycle).

• #21 Brachial plexus injury epidemiology [Neurosurgery Education Wiki]

  https://neurosurgery.education/wiki/doku.php?id=brachial_plexus_injury_epidemiology

  Epidemiological studies of traumatic brachial plexus injuries are few and most of them focus on treatment and prognosis. […] In a population of adult patients with brachial plexus lesions with surgical indication, most of them comprise young male adults involved in high-energy motorcycle accidents. […] Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. […] Brachial plexus injuries occur in 0.1% of pediatric multitrauma patients. Motor vehicle accidents and pedestrians struck by a motor vehicle are the most common reasons for BPIs in this population. […] Traction is the most frequent mechanism related to brachial plexus injuries, and root avulsions are common in these cases. […] In 1997 Midha published that Brachial plexus injury afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%.

• #22 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #23 Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

  https://www.mdpi.com/2411-5142/5/2/22

  Injuries of peripheral nerves can have a wide spectrum of etiology. […] Nevertheless, the involvement of brachial plexus structures due to these systemic and localized diseases is rare. Indeed, in the epidemiology of the etiology of isolated BPIs, traumatic events remain the main cause of injury. […] A closed lesion of the brachial plexus, mainly related to traction of peripheral nerves, represents 93% of traumatic BPIs. […] Motorcycle accidents are the main cause of traumatic BPIs, accounting for 67% of them. […] In occupational or sport activities, data from previous studies reported a pooled prevalence of 10% of traumatic BPIs. […] Some more detailed data about sport activities show an incidence of BPIs among nearly 4% of trauma related to winter sports. […] Obviously, BPIs are a common injury in contact sports but their exact incidence is difficult to estimate.

• #24 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #25 Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

  https://www.mdpi.com/2411-5142/5/2/22

  Injuries of peripheral nerves can have a wide spectrum of etiology. […] Nevertheless, the involvement of brachial plexus structures due to these systemic and localized diseases is rare. Indeed, in the epidemiology of the etiology of isolated BPIs, traumatic events remain the main cause of injury. […] A closed lesion of the brachial plexus, mainly related to traction of peripheral nerves, represents 93% of traumatic BPIs. […] Motorcycle accidents are the main cause of traumatic BPIs, accounting for 67% of them. […] In occupational or sport activities, data from previous studies reported a pooled prevalence of 10% of traumatic BPIs. […] Some more detailed data about sport activities show an incidence of BPIs among nearly 4% of trauma related to winter sports. […] Obviously, BPIs are a common injury in contact sports but their exact incidence is difficult to estimate.

• #26 Brachial Plexus Injuries in Sport Medicine: Clinical Evaluation, Diagnostic Approaches, Treatment Options, and Rehabilitative Interventions

  https://www.mdpi.com/2411-5142/5/2/22

  Injuries of peripheral nerves can have a wide spectrum of etiology. […] Nevertheless, the involvement of brachial plexus structures due to these systemic and localized diseases is rare. Indeed, in the epidemiology of the etiology of isolated BPIs, traumatic events remain the main cause of injury. […] A closed lesion of the brachial plexus, mainly related to traction of peripheral nerves, represents 93% of traumatic BPIs. […] Motorcycle accidents are the main cause of traumatic BPIs, accounting for 67% of them. […] In occupational or sport activities, data from previous studies reported a pooled prevalence of 10% of traumatic BPIs. […] Some more detailed data about sport activities show an incidence of BPIs among nearly 4% of trauma related to winter sports. […] Obviously, BPIs are a common injury in contact sports but their exact incidence is difficult to estimate.

• #27 Epidemiology of brachial plexus injuries in a multitrauma population – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9179891/

  Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting to a regional trauma facility. […] Brachial plexus injuries afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%. […] Head injuries, thoracic injuries, and fractures and dislocations affecting the shoulder girdle and cervical spine are particularly common associated injuries.

• #28

  https://journals.lww.com/neurosurgery/fulltext/1997/06000/epidemiology_of_brachial_plexus_injuries_in_a.14.aspx

  Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting to a regional trauma facility. […] Brachial plexus injuries afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%.

• #29 Blunt traumatic brachial plexus injuries in a northern rural US setting: increased likelihood in unshielded motor-powered crashes | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/5/1/e000558

  Blunt traumatic brachial plexus injuries (BTBPI) are severe peripheral nerve injuries which present in a small portion of trauma patients but can result in long-term neurological disability and severe chronic pain. […] The goal of this study was to describe the epidemiology of BTBPI in a northern rural setting caused by motor-powered collisions, and to determine the relative risk of these injuries in shielded (cars, trucks, vans, and so on) and unshielded vehicles (snowmobiles, all-terrain vehicles and motorcycles). […] Out of all injuries resulting from motor-powered collisions in a 20-year period (9951), BTBPIs were found in 63 trauma patients, a prevalence of 0.6%. The rate of BTBPI involving unshielded vehicles (1.0%) was significantly higher than those involving a shielded vehicle (0.4%) and primarily occurred in rural areas (70%).

• #30 Blunt traumatic brachial plexus injuries in a northern rural US setting: increased likelihood in unshielded motor-powered crashes | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/5/1/e000558

  Unshielded vehicle crashes, particularly snowmobiles, have the highest risk for BTBPI in our rural region. The overall incidence of these injuries appears to be declining. […] BTBPIs are primarily sustained by young males (1935 years old) due to traction or stretching of the brachial plexus. […] The major cause of this injury is high-velocity vehicle crashes. […] In our primarily rural region, we have observed a seemingly higher risk for BTBPIs in snowmobile crashes. […] We hypothesized that unshielded motor vehicle crashes (MVC) are at an increased risk of incurring BTBPI, and that these MVCs would occur in rural areas with higher frequency. […] The overall percentage of BTBPI sustained in a motor-powered collision was found to dramatically drop over the study period. […] The rate of BTBPI resulting from snowmobile collisions (1.8%) was significantly higher than those resulting from motor vehicle collisions (0.4%). Additionally, the number of BTBPIs involving unshielded vehicles (1.0%) was significantly higher than those involving a shielded vehicle (0.4%).

• #31 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #32 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #33 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #34

  https://www.orthobullets.com/trauma/1008/brachial-plexus-injuries

  Brachial plexus injuries (BPIs) can involve any degree of injury at any level of the plexus and range from obstetric injuries to traumatic avulsions. […] 75%-80% of traumatic BPIs are complete involvement of all roots. […] 20%-25% of traumatic BPIs involve C5 and C6 upper trunk (Erb palsy). […] 0.6%-3.0% of traumatic BPIs involve C8, T1 or lower (Klumpke palsy). […] 83% of traumatic BPIs are due to high speed vehicle accidents (mostly motorcycle).

• #35 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #36

  https://www.orthobullets.com/trauma/1008/brachial-plexus-injuries

  Brachial plexus injuries (BPIs) can involve any degree of injury at any level of the plexus and range from obstetric injuries to traumatic avulsions. […] 75%-80% of traumatic BPIs are complete involvement of all roots. […] 20%-25% of traumatic BPIs involve C5 and C6 upper trunk (Erb palsy). […] 0.6%-3.0% of traumatic BPIs involve C8, T1 or lower (Klumpke palsy). […] 83% of traumatic BPIs are due to high speed vehicle accidents (mostly motorcycle).

• #37 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #38

  https://www.orthobullets.com/trauma/1008/brachial-plexus-injuries

  Brachial plexus injuries (BPIs) can involve any degree of injury at any level of the plexus and range from obstetric injuries to traumatic avulsions. […] 75%-80% of traumatic BPIs are complete involvement of all roots. […] 20%-25% of traumatic BPIs involve C5 and C6 upper trunk (Erb palsy). […] 0.6%-3.0% of traumatic BPIs involve C8, T1 or lower (Klumpke palsy). […] 83% of traumatic BPIs are due to high speed vehicle accidents (mostly motorcycle).

• #39 Epidemiology of brachial plexus injuries in a multitrauma population – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9179891/

  Brachial plexus injuries were identified in 54 of 4538 (1.2%) patients presenting to a regional trauma facility. […] Brachial plexus injuries afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%. […] Head injuries, thoracic injuries, and fractures and dislocations affecting the shoulder girdle and cervical spine are particularly common associated injuries.

• #40 Traumatic Brachial Plexopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/316888-overview

  The frequency with which traumatic brachial plexopathies occur varies according the etiology and severity of specific injuries. Brachial plexus injuries are estimated to account for 5% of peripheral nerve injuries. However, the true frequency of injuries to the brachial plexus is undetermined, primarily because of significant underreporting. Prospective studies performed at Tulane University revealed a 7.7% incidence of stingers in a group of college football players; however, other sources have reported a 40% incidence. […] Coexistent musculoskeletal or central nervous system injury, such as spinal cord injury (SCI) or traumatic brain injury (TBI), is common after violent trauma and presents a diagnostic challenge. […] Narakas reported that 80% of patients with severe traumatic brachial plexopathy had multiple trauma to the head and skeletal system.

• #41 Brachial plexus injury epidemiology [Neurosurgery Education Wiki]

  https://neurosurgery.education/wiki/doku.php?id=brachial_plexus_injury_epidemiology

  Epidemiological studies of traumatic brachial plexus injuries are few and most of them focus on treatment and prognosis. […] In a population of adult patients with brachial plexus lesions with surgical indication, most of them comprise young male adults involved in high-energy motorcycle accidents. […] Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. […] Brachial plexus injuries occur in 0.1% of pediatric multitrauma patients. Motor vehicle accidents and pedestrians struck by a motor vehicle are the most common reasons for BPIs in this population. […] Traction is the most frequent mechanism related to brachial plexus injuries, and root avulsions are common in these cases. […] In 1997 Midha published that Brachial plexus injury afflict slightly more than 1% of multitrauma victims. Motorcycle and snowmobile accidents carry especially high risks, with the incidence of injury approaching 5%.

• #42 Traumatic Brachial Plexopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/316888-overview

  The frequency with which traumatic brachial plexopathies occur varies according the etiology and severity of specific injuries. Brachial plexus injuries are estimated to account for 5% of peripheral nerve injuries. However, the true frequency of injuries to the brachial plexus is undetermined, primarily because of significant underreporting. Prospective studies performed at Tulane University revealed a 7.7% incidence of stingers in a group of college football players; however, other sources have reported a 40% incidence. […] Coexistent musculoskeletal or central nervous system injury, such as spinal cord injury (SCI) or traumatic brain injury (TBI), is common after violent trauma and presents a diagnostic challenge. […] Narakas reported that 80% of patients with severe traumatic brachial plexopathy had multiple trauma to the head and skeletal system.

• #43 Traumatic Brachial Plexopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/316888-overview

  A hospital-based, multicenter, observational study by Ciaramitaro et al found that out of 107 patients with traumatic brachial plexus injury, 74 (69%) suffered pain, with 60 (56%) specifically having neuropathic pain. The most frequent and severe form of pain was the spontaneous, burning type. No association was found between pain and age, but pain was determined to be related to the severity of peripheral nerve damage. The investigators also found that neuropathic pain led to depression and impaired quality of life. […] Similarly, a study by Landers et al indicated that the prevalence of posttraumatic stress disorder (PTSD), depression, and suicidal ideation is high in adults who suffer traumatic brachial plexus injury. Evaluating 21 patients, the investigators reported that seven of them (33.3%) admitted to suicidal ideation, while evidence of PTSD and clinical depression was found in four patients (19.0%) each.

• #44 Traumatic Brachial Plexopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/316888-overview

  A hospital-based, multicenter, observational study by Ciaramitaro et al found that out of 107 patients with traumatic brachial plexus injury, 74 (69%) suffered pain, with 60 (56%) specifically having neuropathic pain. The most frequent and severe form of pain was the spontaneous, burning type. No association was found between pain and age, but pain was determined to be related to the severity of peripheral nerve damage. The investigators also found that neuropathic pain led to depression and impaired quality of life. […] Similarly, a study by Landers et al indicated that the prevalence of posttraumatic stress disorder (PTSD), depression, and suicidal ideation is high in adults who suffer traumatic brachial plexus injury. Evaluating 21 patients, the investigators reported that seven of them (33.3%) admitted to suicidal ideation, while evidence of PTSD and clinical depression was found in four patients (19.0%) each.

• #45 Traumatic Brachial Plexus Injuries: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1268993-overview

  Reliable information on the incidence of traumatic brachial plexus injuries has been difficult to obtain; the exact incidence has not been precisely defined. In 1992, Goldie and Coates suggested that 450-500 closed supraclavicular injuries occur each year in the United Kingdom. […] A systematic review of the literature demonstrated that patients had a mean age of 26.4 years, 90.5% were male, and manual labor was the most represented occupation. […] The mean total indirect cost of traumatic brachial plexus injury in the Monte Carlo simulations was $1,113,962 per patient over the postinjury lifetime (median, $801,723; interquartile range, $22,740-2,350,979). […] On the basis of 18 years of experience with 1068 patients, Narakas developed his rule of „seven seventies,” as follows: Approximately 70% were MVAs; Of the MVAs, 70% were motorcycles or bicycles; Of the cycle riders, 70% had multiple injuries; Of the multiple injuries in cycle riders, 70% were supraclavicular injuries; Of the supraclavicular injuries, 70% had at least one root avulsed; Of the avulsed roots, 70% were lower C7, C8, T1; Of the 70% avulsed roots, 70% of those were associated with chronic pain.

• #46 Traumatic Brachial Plexus Injuries: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1268993-overview

  Reliable information on the incidence of traumatic brachial plexus injuries has been difficult to obtain; the exact incidence has not been precisely defined. In 1992, Goldie and Coates suggested that 450-500 closed supraclavicular injuries occur each year in the United Kingdom. […] A systematic review of the literature demonstrated that patients had a mean age of 26.4 years, 90.5% were male, and manual labor was the most represented occupation. […] The mean total indirect cost of traumatic brachial plexus injury in the Monte Carlo simulations was $1,113,962 per patient over the postinjury lifetime (median, $801,723; interquartile range, $22,740-2,350,979). […] On the basis of 18 years of experience with 1068 patients, Narakas developed his rule of „seven seventies,” as follows: Approximately 70% were MVAs; Of the MVAs, 70% were motorcycles or bicycles; Of the cycle riders, 70% had multiple injuries; Of the multiple injuries in cycle riders, 70% were supraclavicular injuries; Of the supraclavicular injuries, 70% had at least one root avulsed; Of the avulsed roots, 70% were lower C7, C8, T1; Of the 70% avulsed roots, 70% of those were associated with chronic pain.

• #47 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #48 Brachial plexus injury – Wikipedia

  https://en.wikipedia.org/wiki/Brachial_plexus_injury

  Brachial plexus injury is found in both children and adults, but there is a difference between children and adults with BPI. […] The prevalence of brachial plexus injuries in North American adults in the 1900s was about 1.2%. Recent data from the UK suggests that the incidence is rising although the methods for capturing such data make computed incidence ratios unreliable. Traumatic BPI is most common in young healthy adults, aged 14 to 63 years old, with 50% of patients between 19 and 34 years old. The majority (89%) are male. […] OBPP, also known as obstetrical brachial plexus palsy, occurs primarily in young children at a rate of 0.38 to 1.56 per 1000 live births depending on the type of care and the average birth weight of infants in different regions of the world. […] BPI has shown to occur in 44% to 70% of traumatic injuries, such as motorcycle accidents, sporting activities, or workplace accidents.

• #49 Brachial plexus injuries | MedLink Neurology

  https://www.medlink.com/articles/brachial-plexus-injuries

  Different patient populations have some variance in the causation and other demographics. The most common causes usually include high-speed motor vehicle accidents, typically involving motorcycles and affecting young adults. Published epidemiology from a polytrauma population had an incidence of brachial plexus injury between 0.67% and 1.3%. Dorsi and colleagues found that brachial plexus injury occurred in 0.1% of pediatric polytrauma patients and that the injuries were most often caused by motor vehicle accidents involving passengers (32%) and pedestrians (17%). Gunshot wounds caused brachial plexus injuries in 12% of the patients. In a selective population, Terzis and colleagues reported that 59% of the cases had sustained injury in motor vehicle crashes. In some studies, motorcycle accidents produced brachial plexus injury twice as often as automobile crashes. This increased injury incidence is due to the large amount of force applied to the unprotected victim on a motorcycle, most often producing a traction injury, unlike automobile crashes where a crush injury is often found. Kaiser and Haninec observed that complete plexus injuries were more common in those not wearing seatbelts, whereas upper plexus injuries were more likely in those wearing seatbelts. Direct compression by hematoma in vascular trauma, metastatic tumors, tumors of the neck, tumors arising from the neural sheath, fractures, and callus can produce brachial plexus injury. Due to its firm attachments to the cervical, fascia brachial plexus is subject to stretch injury or retraction injury during anesthesia or surgery. The incidence of brachial plexus injury during delivery is 0.4 to 4.6 per 1000 live births. Young men are most commonly affected, and there is no right-to-left predilection. Portions of the brachial plexus are more commonly affected by traumatic injury. Chuang reported root and rootlet injury in 70%, postganglionic spinal nerve (interscalene space, proximal to the suprascapular nerve) injury in 8%, trunk and division injury in 5%, and cord and terminal branch injury (proximal to the axillary fossa) in 17%. Chamata and colleagues reported 1.72% prevalence of brachial plexus injuries in patients with scapular fractures. In patients with multiple scapular fractures, the prevalence of brachial plexus injury was 3.12%, ranging from 1.52% to 2.22% in patients with single scapular fractures, depending on the specific anatomical location of the fracture. Of the 426 injuries with detailed information on nerve injury, 208 (49%) involved the radial nerve, 113 (26.5%) the ulnar nerve, 65 (15%) the median nerve, 36 (8.5%) the axillary nerve, and four (1%) the musculocutaneous nerve. The prevalence was similar across anatomical regions for single scapular fracture and was higher with multiple fractures. The largest percentage of nerve injuries was to the radial nerve.

• #50 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #51 Neonatal Brachial Plexus Injury Part 1: Disease/Disorder and Essentials of Assessment | PM&R KnowledgeNow

  https://now.aapmr.org/neonatal-brachial-plexus-injury/

  Globally, NBPI incidence ranges between 0.4 and 4.6 per 1,000 live births. […] There appears to be increased risk of NBPI in non-white patients and patients of lower socioeconomic status. […] In the United States, retrospective analysis of the Kids Inpatient Database from 1997 to 2012 revealed a steady, dramatic reduction (47.1%) in NBPI population incidence from 1.7 to 0.9 per 1,000 live births. […] This marked reduction has been paralleled by increases in cesarean delivery rates (62.8%). […] Cesarean delivery may reduce the risk of vaginal delivery related shoulder dystocia and traction injury and may also be associated with earlier gestational age birth and lower birth weights as evidenced by concurrent down trending fetal macrosomia rates during the study period. […] Alterations in obstetric training and management as well as increased rates of multiparous births may also have contributed to the dramatic reduction.

• #52 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  Obstetric brachial plexus injury (OBPI) is a serious and complex nerve injury in newborns. To date, large-scale studies and guidelines for managing OBPI are scarce, and there are major regional differences in its epidemiology and clinical management. The authors of this national cohort study aimed to report on OBPIs current epidemiology and surgical management strategies in Germany. […] A total of 2069 patients with OBPI who had been hospitalized within their 1st year of life were included in the study. Erb palsy was the most frequent OBPI subtype (66.60%). The total number of live births increased significantly from 685,795 in 2005 to 787,523 in 2018 (p 0.001), resulting in an overall OBPI rate of 0.21 per 1000 births over the years. The incidence of OBPI per 1000 live births significantly decreased by 47.57%, from 0.28 in 2005 to 0.15 in 2018 (p 0.001), representing a mean annual decrease of 0.010 0.026. Subgroup analysis also showed a significant (p 0.001) decrease in all three OBPI subtypes (ICD-10 codes P14.0, P14.1, and P14.3).

• #53 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  OBPI is a rare disease, with a decreasing incidence paralleled by an increase in cesarean birth delivery rates between 2005 and 2018 in Germany. Total surgical management rates rose with a significant trend toward increasing microsurgical explorations and neurolyses. Being large for gestational age was identified as the main infantile risk factor for OBPI.

• #54 Neonatal Brachial Plexus Injury Part 1: Disease/Disorder and Essentials of Assessment | PM&R KnowledgeNow

  https://now.aapmr.org/neonatal-brachial-plexus-injury/

  Globally, NBPI incidence ranges between 0.4 and 4.6 per 1,000 live births. […] There appears to be increased risk of NBPI in non-white patients and patients of lower socioeconomic status. […] In the United States, retrospective analysis of the Kids Inpatient Database from 1997 to 2012 revealed a steady, dramatic reduction (47.1%) in NBPI population incidence from 1.7 to 0.9 per 1,000 live births. […] This marked reduction has been paralleled by increases in cesarean delivery rates (62.8%). […] Cesarean delivery may reduce the risk of vaginal delivery related shoulder dystocia and traction injury and may also be associated with earlier gestational age birth and lower birth weights as evidenced by concurrent down trending fetal macrosomia rates during the study period. […] Alterations in obstetric training and management as well as increased rates of multiparous births may also have contributed to the dramatic reduction.

• #55 Neonatal Brachial Plexus Injury Part 1: Disease/Disorder and Essentials of Assessment | PM&R KnowledgeNow

  https://now.aapmr.org/neonatal-brachial-plexus-injury/

  Globally, NBPI incidence ranges between 0.4 and 4.6 per 1,000 live births. […] There appears to be increased risk of NBPI in non-white patients and patients of lower socioeconomic status. […] In the United States, retrospective analysis of the Kids Inpatient Database from 1997 to 2012 revealed a steady, dramatic reduction (47.1%) in NBPI population incidence from 1.7 to 0.9 per 1,000 live births. […] This marked reduction has been paralleled by increases in cesarean delivery rates (62.8%). […] Cesarean delivery may reduce the risk of vaginal delivery related shoulder dystocia and traction injury and may also be associated with earlier gestational age birth and lower birth weights as evidenced by concurrent down trending fetal macrosomia rates during the study period. […] Alterations in obstetric training and management as well as increased rates of multiparous births may also have contributed to the dramatic reduction.

• #56 Are racial and ethnic disparities in brachial plexus birth injuries explained by known risk factors? | Journal of Perinatology

  https://www.nature.com/articles/s41372-025-02239-8

  Brachial plexus birth injury (BPBI) is a traumatic injury to the nerve roots of the brachial plexus sustained by a newborn during labor and delivery believed to result from expulsive or traction forces on the brachial plexus nerve roots. It presents as upper extremity weakness or paralysis and occurs in approximately 1.5 per 1000 livebirths. Several risk factors for BPBI have been identified, including maternal factors (obesity, diabetes, gestational diabetes), infant factors (birthweight, macrosomia, post-date gestational age) and intrapartum factors (shoulder dystocia, instrumented delivery, vaginal delivery, prolonged labor, precipitous labor). […] Demographic disparities in BPBI risk exist, with Black and Hispanic birthing individuals at increased risk of delivering an affected infant. Compared to a population level incidence of 1.28 BPBI per 1000 livebirths, increased incidences of BPBI have been reported in Black and Hispanic infant deliveries, with 1.78 BPBI per 1000 livebirth among Black infants and 1.34 per 1000 per livebirth among Hispanic infants. Moreover, Black and Hispanic birthing individuals mothers have an 88% and 35% increased odds of delivering an affected infant, respectively, when adjusting for known associations with BPBI, including shoulder dystocia, macrosomia, delivery method and year of birth.

• #57 Are racial and ethnic disparities in brachial plexus birth injuries explained by known risk factors? | Journal of Perinatology

  https://www.nature.com/articles/s41372-025-02239-8

  Brachial plexus birth injury (BPBI) is a traumatic injury to the nerve roots of the brachial plexus sustained by a newborn during labor and delivery believed to result from expulsive or traction forces on the brachial plexus nerve roots. It presents as upper extremity weakness or paralysis and occurs in approximately 1.5 per 1000 livebirths. Several risk factors for BPBI have been identified, including maternal factors (obesity, diabetes, gestational diabetes), infant factors (birthweight, macrosomia, post-date gestational age) and intrapartum factors (shoulder dystocia, instrumented delivery, vaginal delivery, prolonged labor, precipitous labor). […] Demographic disparities in BPBI risk exist, with Black and Hispanic birthing individuals at increased risk of delivering an affected infant. Compared to a population level incidence of 1.28 BPBI per 1000 livebirths, increased incidences of BPBI have been reported in Black and Hispanic infant deliveries, with 1.78 BPBI per 1000 livebirth among Black infants and 1.34 per 1000 per livebirth among Hispanic infants. Moreover, Black and Hispanic birthing individuals mothers have an 88% and 35% increased odds of delivering an affected infant, respectively, when adjusting for known associations with BPBI, including shoulder dystocia, macrosomia, delivery method and year of birth.

• #58

  https://www.orthobullets.com/pediatrics/4117/obstetric-brachial-plexopathy-erbs-klumpkes-palsy

  Obstetric Brachial Plexopathy is injury to the brachial plexus that occurs during birth usually as a result of a stretching injury from a difficult vaginal delivery. […] Epidemiology […] Incidence […] approximately 1 to 4 per 1,000 live births […] decreasing in frequency due to improved obstetric care. […] Anatomic location […] often right sided or bilateral. […] Risk factors […] large for gestational age (macrosomia) […] multiparous pregnancy […] difficult presentation […] shoulder dystocia […] forceps delivery […] breech position […] prolonged labor.

• #59 Are racial and ethnic disparities in brachial plexus birth injuries explained by known risk factors? | Journal of Perinatology

  https://www.nature.com/articles/s41372-025-02239-8

  Brachial plexus birth injury (BPBI) is a traumatic injury to the nerve roots of the brachial plexus sustained by a newborn during labor and delivery believed to result from expulsive or traction forces on the brachial plexus nerve roots. It presents as upper extremity weakness or paralysis and occurs in approximately 1.5 per 1000 livebirths. Several risk factors for BPBI have been identified, including maternal factors (obesity, diabetes, gestational diabetes), infant factors (birthweight, macrosomia, post-date gestational age) and intrapartum factors (shoulder dystocia, instrumented delivery, vaginal delivery, prolonged labor, precipitous labor). […] Demographic disparities in BPBI risk exist, with Black and Hispanic birthing individuals at increased risk of delivering an affected infant. Compared to a population level incidence of 1.28 BPBI per 1000 livebirths, increased incidences of BPBI have been reported in Black and Hispanic infant deliveries, with 1.78 BPBI per 1000 livebirth among Black infants and 1.34 per 1000 per livebirth among Hispanic infants. Moreover, Black and Hispanic birthing individuals mothers have an 88% and 35% increased odds of delivering an affected infant, respectively, when adjusting for known associations with BPBI, including shoulder dystocia, macrosomia, delivery method and year of birth.

• #60

  https://www.orthobullets.com/pediatrics/4117/obstetric-brachial-plexopathy-erbs-klumpkes-palsy

  Obstetric Brachial Plexopathy is injury to the brachial plexus that occurs during birth usually as a result of a stretching injury from a difficult vaginal delivery. […] Epidemiology […] Incidence […] approximately 1 to 4 per 1,000 live births […] decreasing in frequency due to improved obstetric care. […] Anatomic location […] often right sided or bilateral. […] Risk factors […] large for gestational age (macrosomia) […] multiparous pregnancy […] difficult presentation […] shoulder dystocia […] forceps delivery […] breech position […] prolonged labor.

• #61 Brachial Plexus Birth Injury | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/brachial-plexus-birth-injury

  Brachial plexus birth injury, also known as brachial plexus injury, is an injury to the brachial plexus nerves that occurs in about one to three out of every 1,000 births. […] The causes of brachial plexus injury may include: large gestational size, breech birth, prolonged or difficult labor, vacuum- or forceps-assisted delivery, twin or multiple pregnancy, history of a prior delivery resulting in brachial plexus birth injury. […] As a national and international referral center for children with brachial plexus injury, the Brachial Plexus Program within the Orthopedics and Sports Medicine Department at Boston Children’s Hospital is among the largest in the world.

• #62

  https://www.orthobullets.com/pediatrics/4117/obstetric-brachial-plexopathy-erbs-klumpkes-palsy

  Obstetric Brachial Plexopathy is injury to the brachial plexus that occurs during birth usually as a result of a stretching injury from a difficult vaginal delivery. […] Epidemiology […] Incidence […] approximately 1 to 4 per 1,000 live births […] decreasing in frequency due to improved obstetric care. […] Anatomic location […] often right sided or bilateral. […] Risk factors […] large for gestational age (macrosomia) […] multiparous pregnancy […] difficult presentation […] shoulder dystocia […] forceps delivery […] breech position […] prolonged labor.

• #63 Neonatal Brachial Plexus Injury Part 1: Disease/Disorder and Essentials of Assessment | PM&R KnowledgeNow

  https://now.aapmr.org/neonatal-brachial-plexus-injury/

  Up to 71% of patients had no risk factor and 46-54% of cases occur in the absence of shoulder dystocia. […] Primary prevention includes early recognition of risk factors. Additionally, training programs emphasizing proper implementation of preventive obstetric maneuvers in response to complicated deliveries are recommended. […] Surveillance imaging is critically important in monitoring glenohumeral joint integrity, growth, and development in children with NBPI. […] Glenoid dysplasia characterized by retroverted glenoid, flattened humeral head, and posterior subluxation/dislocation is frequent. […] Dynamic ultrasound is the preferred initial modality for screening evaluation of glenohumeral dysplasia and malalignment. […] MRI is the gold standard for grading of glenohumeral deformity and surgical planning.

• #64 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  Obstetric brachial plexus injury (OBPI) is a serious and complex nerve injury in newborns. To date, large-scale studies and guidelines for managing OBPI are scarce, and there are major regional differences in its epidemiology and clinical management. The authors of this national cohort study aimed to report on OBPIs current epidemiology and surgical management strategies in Germany. […] A total of 2069 patients with OBPI who had been hospitalized within their 1st year of life were included in the study. Erb palsy was the most frequent OBPI subtype (66.60%). The total number of live births increased significantly from 685,795 in 2005 to 787,523 in 2018 (p 0.001), resulting in an overall OBPI rate of 0.21 per 1000 births over the years. The incidence of OBPI per 1000 live births significantly decreased by 47.57%, from 0.28 in 2005 to 0.15 in 2018 (p 0.001), representing a mean annual decrease of 0.010 0.026. Subgroup analysis also showed a significant (p 0.001) decrease in all three OBPI subtypes (ICD-10 codes P14.0, P14.1, and P14.3).

• #65

  https://www.orthobullets.com/pediatrics/4117/obstetric-brachial-plexopathy-erbs-klumpkes-palsy

  Obstetric Brachial Plexopathy is injury to the brachial plexus that occurs during birth usually as a result of a stretching injury from a difficult vaginal delivery. […] Epidemiology […] Incidence […] approximately 1 to 4 per 1,000 live births […] decreasing in frequency due to improved obstetric care. […] Anatomic location […] often right sided or bilateral. […] Risk factors […] large for gestational age (macrosomia) […] multiparous pregnancy […] difficult presentation […] shoulder dystocia […] forceps delivery […] breech position […] prolonged labor.

• #66 Brachial Plexus Palsy | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/brachial-plexus-palsy

  Neonatal brachial plexus palsies (NBPP) are a group of neurologic injuries of the brachial plexus observed in newborns. […] The overall cumulative incidence of NBPP (transient and persistent) is rare, noted in 0.15% of all births. […] In deliveries with documented shoulder dystocia complications, the rate of transient NBPP may be as high as 1-17% and in the range of 0.5-1.6% for NBPP that persists one year or longer post-delivery. […] The incidence of both transient and persistent NBPP together in deliveries without documented shoulder dystocia was found to be 0.9%. […] NBPP is also found in cesarean deliveries, with an incidence of 0.03-0.15%. […] In approximately 5% of all NBPP cases there is bilateral involvement. […] Functional impairment that does not spontaneously resolve within three months can be seen in approximately 18-50% of patients.

• #67 Brachial Plexus Injury | Living With Paralysis | Reeve Foundation

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/brachial-plexus-injury/

  Brachial plexus injury at birth occurs in 1-2/1000 births. Spontaneous recovery rate is 66%. […] Trends in brachial plexus injury is lowering in vaginal births but increasing in cesarean section births. […] The number of adult and teen brachial plexus injuries is rising due to motor vehicle accidents and sports-related injury. […] In a study by Kaiser, et al. (2020) rate and types of brachial plexus injuries in adults are: […] Brachial Plexus Injury rates are closed (no skin opening) 93%, lacerations 3%, gunshot wounds (GSWs) 3%. […] Cause of closed brachial plexus injuries was motorcycle accidents 67%, car crashes 14%. […] Complete lesions 53%, upper plexus injury 39%, lower plexus injury 6%. […] Males outnumber females 9:1.

• #68 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #69 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #70 Brachial Plexus Palsy | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/brachial-plexus-palsy

  Neonatal brachial plexus palsies (NBPP) are a group of neurologic injuries of the brachial plexus observed in newborns. […] The overall cumulative incidence of NBPP (transient and persistent) is rare, noted in 0.15% of all births. […] In deliveries with documented shoulder dystocia complications, the rate of transient NBPP may be as high as 1-17% and in the range of 0.5-1.6% for NBPP that persists one year or longer post-delivery. […] The incidence of both transient and persistent NBPP together in deliveries without documented shoulder dystocia was found to be 0.9%. […] NBPP is also found in cesarean deliveries, with an incidence of 0.03-0.15%. […] In approximately 5% of all NBPP cases there is bilateral involvement. […] Functional impairment that does not spontaneously resolve within three months can be seen in approximately 18-50% of patients.

• #71 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #72 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #73 Epidemiology of peripheral nerve and brachial plexus injuries in a trauma population | CJS

  https://www.canjsurg.ca/content/67/3/E261

  Understanding patterns of peripheral nerve injuries (PNIs) and brachial plexus injuries (BPIs) is essential to preventing and appropriately managing nerve injuries. […] The epidemiology of PNI and BPI in the trauma population remains minimally understood. […] Epidemiological studies from the 1990s found a prevalence of 2.8% for PNI and 1.2% for BPI in a trauma population from a tertiary trauma centre. […] Our study found a 1.6% prevalence of nerve injuries in a trauma population over the last 18 years (2002-2020), with a 1.3% prevalence of PNIs and a 0.3% prevalence of BPIs. […] Compared with previous studies at the same institution, which reported a prevalence of 2.8% for PNIs and 1.2% for BPIs, we found a decrease in nerve injuries. […] The longer time to diagnosis and increased use of diagnostic testing for patients with BPI may be associated with the high number of sharp injuries among patients with PNIs in our sample and may also highlight the difficulty in identifying BPIs in the acute trauma setting. […] Although the prevalence of nerve injuries within the trauma population has decreased in the last 3 decades, there have been shifts in mechanisms of injury, surgical treatments, and the use of electrodiagnostic tests for diagnosis.

• #74 Epidemiology of peripheral nerve and brachial plexus injuries in a trauma population | CJS

  https://www.canjsurg.ca/content/67/3/E261

  Understanding patterns of peripheral nerve injuries (PNIs) and brachial plexus injuries (BPIs) is essential to preventing and appropriately managing nerve injuries. […] The epidemiology of PNI and BPI in the trauma population remains minimally understood. […] Epidemiological studies from the 1990s found a prevalence of 2.8% for PNI and 1.2% for BPI in a trauma population from a tertiary trauma centre. […] Our study found a 1.6% prevalence of nerve injuries in a trauma population over the last 18 years (2002-2020), with a 1.3% prevalence of PNIs and a 0.3% prevalence of BPIs. […] Compared with previous studies at the same institution, which reported a prevalence of 2.8% for PNIs and 1.2% for BPIs, we found a decrease in nerve injuries. […] The longer time to diagnosis and increased use of diagnostic testing for patients with BPI may be associated with the high number of sharp injuries among patients with PNIs in our sample and may also highlight the difficulty in identifying BPIs in the acute trauma setting. […] Although the prevalence of nerve injuries within the trauma population has decreased in the last 3 decades, there have been shifts in mechanisms of injury, surgical treatments, and the use of electrodiagnostic tests for diagnosis.

• #75 Neonatal Brachial Plexus Injury Part 1: Disease/Disorder and Essentials of Assessment | PM&R KnowledgeNow

  https://now.aapmr.org/neonatal-brachial-plexus-injury/

  Globally, NBPI incidence ranges between 0.4 and 4.6 per 1,000 live births. […] There appears to be increased risk of NBPI in non-white patients and patients of lower socioeconomic status. […] In the United States, retrospective analysis of the Kids Inpatient Database from 1997 to 2012 revealed a steady, dramatic reduction (47.1%) in NBPI population incidence from 1.7 to 0.9 per 1,000 live births. […] This marked reduction has been paralleled by increases in cesarean delivery rates (62.8%). […] Cesarean delivery may reduce the risk of vaginal delivery related shoulder dystocia and traction injury and may also be associated with earlier gestational age birth and lower birth weights as evidenced by concurrent down trending fetal macrosomia rates during the study period. […] Alterations in obstetric training and management as well as increased rates of multiparous births may also have contributed to the dramatic reduction.

• #76 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  OBPI is a rare disease, with a decreasing incidence paralleled by an increase in cesarean birth delivery rates between 2005 and 2018 in Germany. Total surgical management rates rose with a significant trend toward increasing microsurgical explorations and neurolyses. Being large for gestational age was identified as the main infantile risk factor for OBPI.

• #77 Brachial Plexus Injury | Living With Paralysis | Reeve Foundation

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/brachial-plexus-injury/

  Brachial plexus injury at birth occurs in 1-2/1000 births. Spontaneous recovery rate is 66%. […] Trends in brachial plexus injury is lowering in vaginal births but increasing in cesarean section births. […] The number of adult and teen brachial plexus injuries is rising due to motor vehicle accidents and sports-related injury. […] In a study by Kaiser, et al. (2020) rate and types of brachial plexus injuries in adults are: […] Brachial Plexus Injury rates are closed (no skin opening) 93%, lacerations 3%, gunshot wounds (GSWs) 3%. […] Cause of closed brachial plexus injuries was motorcycle accidents 67%, car crashes 14%. […] Complete lesions 53%, upper plexus injury 39%, lower plexus injury 6%. […] Males outnumber females 9:1.

• #78 Brachial Plexus Injury | Living With Paralysis | Reeve Foundation

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/brachial-plexus-injury/

  Brachial plexus injury at birth occurs in 1-2/1000 births. Spontaneous recovery rate is 66%. […] Trends in brachial plexus injury is lowering in vaginal births but increasing in cesarean section births. […] The number of adult and teen brachial plexus injuries is rising due to motor vehicle accidents and sports-related injury. […] In a study by Kaiser, et al. (2020) rate and types of brachial plexus injuries in adults are: […] Brachial Plexus Injury rates are closed (no skin opening) 93%, lacerations 3%, gunshot wounds (GSWs) 3%. […] Cause of closed brachial plexus injuries was motorcycle accidents 67%, car crashes 14%. […] Complete lesions 53%, upper plexus injury 39%, lower plexus injury 6%. […] Males outnumber females 9:1.

• #79 Blunt traumatic brachial plexus injuries in a northern rural US setting: increased likelihood in unshielded motor-powered crashes | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/5/1/e000558

  Unshielded vehicle crashes, particularly snowmobiles, have the highest risk for BTBPI in our rural region. The overall incidence of these injuries appears to be declining. […] BTBPIs are primarily sustained by young males (1935 years old) due to traction or stretching of the brachial plexus. […] The major cause of this injury is high-velocity vehicle crashes. […] In our primarily rural region, we have observed a seemingly higher risk for BTBPIs in snowmobile crashes. […] We hypothesized that unshielded motor vehicle crashes (MVC) are at an increased risk of incurring BTBPI, and that these MVCs would occur in rural areas with higher frequency. […] The overall percentage of BTBPI sustained in a motor-powered collision was found to dramatically drop over the study period. […] The rate of BTBPI resulting from snowmobile collisions (1.8%) was significantly higher than those resulting from motor vehicle collisions (0.4%). Additionally, the number of BTBPIs involving unshielded vehicles (1.0%) was significantly higher than those involving a shielded vehicle (0.4%).

• #80 Traumatic Brachial Plexus Injuries: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1268993-overview

  Reliable information on the incidence of traumatic brachial plexus injuries has been difficult to obtain; the exact incidence has not been precisely defined. In 1992, Goldie and Coates suggested that 450-500 closed supraclavicular injuries occur each year in the United Kingdom. […] A systematic review of the literature demonstrated that patients had a mean age of 26.4 years, 90.5% were male, and manual labor was the most represented occupation. […] The mean total indirect cost of traumatic brachial plexus injury in the Monte Carlo simulations was $1,113,962 per patient over the postinjury lifetime (median, $801,723; interquartile range, $22,740-2,350,979). […] On the basis of 18 years of experience with 1068 patients, Narakas developed his rule of „seven seventies,” as follows: Approximately 70% were MVAs; Of the MVAs, 70% were motorcycles or bicycles; Of the cycle riders, 70% had multiple injuries; Of the multiple injuries in cycle riders, 70% were supraclavicular injuries; Of the supraclavicular injuries, 70% had at least one root avulsed; Of the avulsed roots, 70% were lower C7, C8, T1; Of the 70% avulsed roots, 70% of those were associated with chronic pain.

• #81 Traumatic Brachial Plexopathy: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/316888-overview

  The frequency with which traumatic brachial plexopathies occur varies according the etiology and severity of specific injuries. Brachial plexus injuries are estimated to account for 5% of peripheral nerve injuries. However, the true frequency of injuries to the brachial plexus is undetermined, primarily because of significant underreporting. Prospective studies performed at Tulane University revealed a 7.7% incidence of stingers in a group of college football players; however, other sources have reported a 40% incidence. […] Coexistent musculoskeletal or central nervous system injury, such as spinal cord injury (SCI) or traumatic brain injury (TBI), is common after violent trauma and presents a diagnostic challenge. […] Narakas reported that 80% of patients with severe traumatic brachial plexopathy had multiple trauma to the head and skeletal system.

• #82 Rehabilitation of brachial plexus injury in contact sport: Where are the data that underpin clinical management? A scoping review | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0298317

  Although a common injury there is a lack of published primary data to inform clinical management of sports related brachial plexus injuries. […] There is a distinct lack of data available to inform evidence-based rehabilitation management of sports related brachial plexus injury. Only 8 individual case reports contain published data reporting on 10 athletes. Further reporting is critical to inform clinical management. […] Despite the potential for severe and debilitating outcomes resulting from BPI in the sporting athlete, there is a distinct lack of evidence supporting rehabilitation management approaches or the rationale for setting return to play criteria. […] Although thought to be a relatively common injury, there is a lack of consensus guidance as to the clinical management of sports related brachial plexus injuries. The published primary data as to rehabilitation of sports related BPI is very poor, essentially consisting of 8 case reports relating to 10 individuals. Further data reporting is critical to inform clinical management. Alongside vastly more data, standardised methods of assessment, diagnostic testing, outcome evaluation and reporting across the spectrum of severity of BPI presentation are all needed to facilitate rehabilitation and return to play guidance.

• #83 Rehabilitation of brachial plexus injury in contact sport: Where are the data that underpin clinical management? A scoping review | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0298317

  Although a common injury there is a lack of published primary data to inform clinical management of sports related brachial plexus injuries. […] There is a distinct lack of data available to inform evidence-based rehabilitation management of sports related brachial plexus injury. Only 8 individual case reports contain published data reporting on 10 athletes. Further reporting is critical to inform clinical management. […] Despite the potential for severe and debilitating outcomes resulting from BPI in the sporting athlete, there is a distinct lack of evidence supporting rehabilitation management approaches or the rationale for setting return to play criteria. […] Although thought to be a relatively common injury, there is a lack of consensus guidance as to the clinical management of sports related brachial plexus injuries. The published primary data as to rehabilitation of sports related BPI is very poor, essentially consisting of 8 case reports relating to 10 individuals. Further data reporting is critical to inform clinical management. Alongside vastly more data, standardised methods of assessment, diagnostic testing, outcome evaluation and reporting across the spectrum of severity of BPI presentation are all needed to facilitate rehabilitation and return to play guidance.

• #84 The evaluation and management of neonatal brachial plexus palsy | Canadian Paediatric Society

  https://cps.ca/documents/position/neonatal-brachial-plexus-palsy

  Neonatal brachial plexus palsy (NBPP), defined as weakness or flaccid paralysis of the upper extremity diagnosed soon after birth, results from injury of one or more cervical and thoracic nerve roots (C5T1). The global incidence of NBPP ranges between 0.38 to 5.1/1000 live births, with regional variations depending on study setting (e.g., single centre, select populations), population-based data, and the availability of maternal-fetal care. The incidence of NBPP in Canada, based on Canadian Institute for Health Information (CIHI) data, has been estimated at 1.24/1000 live births, with rates remaining stable from 2004 to 2012. […] Regularly scheduled clinical examinations just after birth and throughout the neonatal period are essential to assess recovery, especially because nerve injuries of different severity present with the similar clinical features. One systematic review of prospective and retrospective studies on the natural history of NBPP has suggested that 20% to 30% of infants in demographic samples do not recover fully. Recovery in infants with Erbs palsy ranges from 69% to 95%, while almost 80% of children with global C5-T1 injuries have persistent deficits at 18 months. The long-term consequences of persistent NBPP may include weakness, development of skeletal malformations (e.g., contractures, limb length discrepancy), and cosmetic deformities.

• #85 Epidemiology of Adult Traumatic Brachial Plexus Injuries | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-030-69517-0_5

  Adult traumatic brachial plexus injuries (BPI) are devastating lesions that affect function and daily living activities and also have a substantial social, economic, and psychological impact, creating lifelong disabilities. […] Epidemiological studies of BPI are critical for addressing the magnitude of the problem and determining the characteristics of the affected individuals in order to create prevention plans and treatment. […] BPI are not common; the estimated annual incidence of BPI in the general population lies between 0.17/100,000/year and 1.6/100,000/year. […] Traumatic brachial plexus injuries occur more frequently in young male patients, and most are closed lesions caused by road traffic accidents (motorcycles) involving the supraclavicular plexus. […] Open lacerations and gunshot wounds are less common among civilian populations.

• #86 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #87

  https://link.springer.com/article/10.1007/s10143-018-1009-2

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 8797%), lacerations accounted for 3% (95% CI: 16%), and gunshot wounds (GSWs) for 3% (95% CI: 07%). The prevalence of male patients was 93% (95% CI: 9096%) and female cases 7% (95% CI: 410%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 4982%) prevalence followed by car crashes with 14% (95% CI: 820%). Other causes were rare. Ninety percent (95% CI: 7898%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 222%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 4758%) followed by upper plexus lesion with 39% (95% CI: 3148%) and lower plexus injury with 6% (95% CI: 112%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare. […] Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40:11821188 discussion 1188-1189. […] Goldie BS, Coates CJ (1992) Brachial plexus injury: a survey of incidence and referral pattern. J Hand Surg 17:8688.

• #88 Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30014280/

  The literature describing epidemiology, etiology, and types of serious brachial plexus injuries (BPIs) is sparse. The aim of this review was to investigate the epidemiological and etiopathogenetical data of serious BPIs undergoing surgical reconstruction. A systematic search was conducted from January 1985 to December 2017. All studies that reported data about prevalence of specific types and causes of BPIs in adults treated surgically were included and cumulatively analyzed. Ten studies including 3032 patients were identified. The pooled prevalence of closed BPIs was 93% (95% CI: 87-97%), lacerations accounted for 3% (95% CI: 1-6%), and gunshot wounds (GSWs) for 3% (95% CI: 0-7%). The prevalence of male patients was 93% (95% CI: 90-96%) and female cases 7% (95% CI: 4-10%). The most common cause of closed BPI was motorcycle accidents with 67% (95% CI: 49-82%) prevalence followed by car crashes with 14% (95% CI: 8-20%). Other causes were rare. Ninety percent (95% CI: 78-98%) of patients suffered from a supraclavicular or combined supra-/infraclavicular trauma, while 10% (95% CI: 2-22%) from isolated infraclavicular injury. The prevalence of complete lesions was 53% (95% CI: 47-58%) followed by upper plexus lesion with 39% (95% CI: 31-48%) and lower plexus injury with 6% (95% CI: 1-12%). This meta-analysis demonstrates that the typical patient suffering from severe BPI is a male after motorcycle accident with closed supraclavicular injury causing complete or slightly less commonly upper plexus palsy. Lacerations and GSWs of brachial plexus are rare.

• #89 Neonatal Brachial Plexus Injury Part 1: Disease/Disorder and Essentials of Assessment | PM&R KnowledgeNow

  https://now.aapmr.org/neonatal-brachial-plexus-injury/

  Globally, NBPI incidence ranges between 0.4 and 4.6 per 1,000 live births. […] There appears to be increased risk of NBPI in non-white patients and patients of lower socioeconomic status. […] In the United States, retrospective analysis of the Kids Inpatient Database from 1997 to 2012 revealed a steady, dramatic reduction (47.1%) in NBPI population incidence from 1.7 to 0.9 per 1,000 live births. […] This marked reduction has been paralleled by increases in cesarean delivery rates (62.8%). […] Cesarean delivery may reduce the risk of vaginal delivery related shoulder dystocia and traction injury and may also be associated with earlier gestational age birth and lower birth weights as evidenced by concurrent down trending fetal macrosomia rates during the study period. […] Alterations in obstetric training and management as well as increased rates of multiparous births may also have contributed to the dramatic reduction.

• #90 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  OBPI is a rare disease, with a decreasing incidence paralleled by an increase in cesarean birth delivery rates between 2005 and 2018 in Germany. Total surgical management rates rose with a significant trend toward increasing microsurgical explorations and neurolyses. Being large for gestational age was identified as the main infantile risk factor for OBPI.

• #91 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  Obstetric brachial plexus injury (OBPI) is a serious and complex nerve injury in newborns. To date, large-scale studies and guidelines for managing OBPI are scarce, and there are major regional differences in its epidemiology and clinical management. The authors of this national cohort study aimed to report on OBPIs current epidemiology and surgical management strategies in Germany. […] A total of 2069 patients with OBPI who had been hospitalized within their 1st year of life were included in the study. Erb palsy was the most frequent OBPI subtype (66.60%). The total number of live births increased significantly from 685,795 in 2005 to 787,523 in 2018 (p 0.001), resulting in an overall OBPI rate of 0.21 per 1000 births over the years. The incidence of OBPI per 1000 live births significantly decreased by 47.57%, from 0.28 in 2005 to 0.15 in 2018 (p 0.001), representing a mean annual decrease of 0.010 0.026. Subgroup analysis also showed a significant (p 0.001) decrease in all three OBPI subtypes (ICD-10 codes P14.0, P14.1, and P14.3).

• #92 Epidemiology and surgical management of obstetric brachial plexus injury: a national cohort study in: Journal of Neurosurgery: Pediatrics – Ahead of print Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2025.1.PEDS24626/article-10.3171-2025.1.PEDS24626.xml

  OBPI is a rare disease, with a decreasing incidence paralleled by an increase in cesarean birth delivery rates between 2005 and 2018 in Germany. Total surgical management rates rose with a significant trend toward increasing microsurgical explorations and neurolyses. Being large for gestational age was identified as the main infantile risk factor for OBPI.

Zobacz więcej