Distribution and extent of involvement in brachial plexopathies caused by gunshot wounds, motor vehicle crashes, and other etiologies: A 10-year electromyography study

Objective: To examine the differences in the extent and distribution of brachial plexopathy involvement caused by gunshot wounds (GSW), motor vehicle crashes (MVCs), and other etiologies, based on electrophysiologic data. Design: Retrospective review of electrophysiologic data from 1993 to 2002. Setting: A large urban county hospital. Participants: Sequential patients (N=109) with the diagnosis of brachial plexopathy established by electromyography testing. This included 35 patients with GSW, 25 involved in an MVC, and 49 with other etiologies. Interventions: Not applicable. Main Outcome Measures: The brachial plexus was divided into 9 regions: upper, middle, and lower root; upper, middle, and lower trunks; and lateral, posterior, and medial cords. Regions involved by needle study on electromyography were denoted as positive or negative. The total number of regions involved was also recorded. Results: Injury was most common in the trunks (52%), cords (36%), and roots (12%) (Pearson chi(2), P<.000). Specifically, the "other" category had the greatest number of injuries to the trunks (54%) (Pearson chi(2), P<.000), whereas the trunks (46%) and cords (45%) were more evenly affected in GSW cases (Pearson chi(2), P=.585). In the MVC group, there was a trend toward more trunks (56%) being affected (Pearson chi(2), P=.076). Conclusions: Differences were noted in the distribution of injury when examining subtypes of traumatic brachial plexopathies. (C) 2004 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.