LOW-VELOCITY GUN SHOT WOUNDS OF THE BRACHIAL-PLEXUS

28 patients with low velocity gunshot wounds of the brachial plexus we re treated at Groote Schuur Hospital from 1980 to 1991. Delayed explor ation of the brachial plexus (up to 7 months after injury) was perform ed in nine (30%) of the patients. The other 19 patients did not have e xploration of the plexus; most of these patients showed signs of recov ery within 2 to 4 weeks of injury. Injury to the subclavian or axillar y artery occurred in nine (30%) of the cases. The average length of fo llow-up of the patients was 19 months (range 2-90 months). Of the 19 p atients treated non-operatively, 15 (79%) had an excellent or good res ult and four (21%) a fair result. The indications for surgery were the absence of improvement within 3 months of injury or persistent pain. Surgery was indicated for significant pain in five of the nine patient s; post-operatively two had complete relief of pain, two improvement i n the pain and one no improvement. Of the nine surgically treated pati ents, three (33%) had a good result, two (22%) a fair result and four (45%) a poor result. The potential for recovery was not dependent on t he severity of the injury at presentation or the presence of vascular injury but on the appearance of signs of recovery within 4 weeks of in jury.