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Prognostic value of needle electromyography in traumatic brachial plexus injury
Author(s) -
Impastato David M.,
Impastato Katherine A.,
Dabestani Parinaz,
Ko Jason H.,
Bunnell Aaron E.
Publication year - 2019
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26684
Subject(s) - biceps , medicine , brachial plexus , brachial plexus injury , deltoid curve , electromyography , deltoid muscle , motor unit , trauma center , retrospective cohort study , physical therapy , surgery , physical medicine and rehabilitation , anesthesia , anatomy
In this study we aimed to determine whether needle electromyographic assessment of voluntary motor unit recruitment in traumatic brachial plexus injuries could predict spontaneous motor recovery. Methods A retrospective study was performed on patients with brachial plexus injury affecting deltoid, supraspinatus/infraspinatus, and biceps brachii. The outcome measure was strength on manual muscle testing at least 1 year after injury. Good outcome was considered strength >3/5 on the Medical Research Council (MRC) scale. Results No muscles with no recruitment (n = 27) at 1‐9 months improved to MRC 4/5 strength at a mean of 2.0 years postinjury. Twenty‐five percent of muscles with discrete or severely reduced recruitment (n = 8) regained strength to >3/5 at a mean of 1.4 years postinjury ( P = .047). Discussion Absent voluntary motor unit potential recruitment at 1‐9 months predicted poor prognosis for spontaneous recovery. A high percentage of patients with discrete recruitment did not improve to >3/5 strength. These patients should be considered for early nerve transfer surgery.