Demographic and Clinical Characteristics of Brachial Plexus Injury at Kirtipur Hospital

Abstract

Introduction: Brachial plexus injury is a devastating condition causing significant motor and sensory impairment of the upper limb, 
often resulting in long-term disability. Road traffic accidents, particularly involving motorcycles, are the leading cause of adult brachial plexus injury worldwide. Despite the increasing incidence of trauma in Nepal, there is limited epidemiological data regarding brachial plexus injury.

Aims: To evaluate the demographic characteristics, mechanisms of injury, and clinical presentation patterns of adult brachial plexus injuries.

Methods: A retrospective observational study was conducted by reviewing medical records of adult patients diagnosed with brachial plexus injury at Kirtipur Hospital over a five-years period (2019–2025). Demographic characteristics, mechanism of injury, side involved, type and level of nerve involvement, associated injuries, and time from injury to presentation were analyzed. Patients with clinically and/or electromyographically confirmed brachial plexus injury were included.

Results: A total of 108 patients with adult brachial plexus injury were included. The mean age was 29.02 years, with 87% of patients belonging to the 20–50 years age group. Male constituted 88% of cases. Right-sided injuries were more common (70.4%). Road traffic accidents accounted for 83.3% of injuries, with two-wheeler accidents comprising 96.7% of road traffic accidents. Supraclavicular injuries were the most common type (84.4%). Total plexus palsy (C5–T1) was the most frequent pattern of injury (24.76%), followed by upper plexus (C5–C6) injuries (22.86%). Associated injuries were present in 42.59% of patients, predominantly involving the upper limb. The mean time to presentation was 5.74 months.

Conclusion: Brachial plexus injury in Nepal predominantly affects young adult males involved in high-energy trauma, particularly two-wheeler accidents. Supraclavicular injuries and total plexus palsy were the most common clinical presentations. These findings emphasize the need for preventive road safety measures, early recognition, and timely referral to specialized centres.