Elective Amputation Beneficial for Some With Brachial Plexus Injury

FRIDAY, July 15, 2022 (HealthDay News) -- Select patients with traumatic brachial plexus injury (BPI) who undergo elective amputation after unsuccessful surgical reconstruction report reduced pain and high satisfaction, according to research published online June 22 in the Journal of Bone & Joint Surgery.

Sean R. Cantwell, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a retrospective review of 32 patients with BPI who underwent elective upper-extremity amputation following unsuccessful surgical reconstruction or delayed presentation. The results of amputation with and without a myoelectric prosthesis (MEP) were compared.

Amputation occurred at 48.9 months after BPI, on average. Ten patients were fitted for an MEP with electromyographic signal control from muscles that were not usually associated with the function intended. The researchers found that postamputation, there was a decrease in average visual analog scale pain scores, from 4.8 to 3.3 for the MEP group and from 5.4 to 4.4 for the non-MEP group. Postamputation, there was a decrease observed in the average scores on the Disabilities of the Arm, Shoulder, and Hand questionnaire, which was not significant. Employment was more likely for patients after versus before amputation. None of the patients expressed regret about amputation. All patients in the MEP group and 29 percent with a traditional prosthesis reported regular use of the prosthesis. Functional terminal grasp/release that was considered useful was reported by all patients in the MEP group.

"Continued improvement in prosthetic technology may allow for MEPs to facilitate a degree of terminal extremity control unachievable through reconstructive surgery for proximal panplexus injuries," the authors write.

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