Comparing treatment algorithms in adult brachial plexus injury
A prospective observational study
comparing treatment strategies in adult brachial plexus injury
Goal is to find the most effective and efficient treatment strategy for better outcomes after severe brachial plexus injury
Research Questions
Optimal strategy?
What is the best surgical strategy for reconstruction of arm and hand function in adult traumatic brachial plexus injury?
Optimal setting?
What is the best treatment strategy and setting for treatement of rare ATBPI in terms of functional outcome and QoL?
Background
Current level of evidence is low
There is a wide variety in treatment algorithms for arm function reconstruction after Adult Brachial Plexus Injury.
There is a need for international and multidisciplinary collaboration in which past dogmas will be left behind and innovative approaches undertaken.
Outcome?
There are no studies performed on functional outcome and Quality of Life (QoL) in ABPI;
Primary/Secondary
Reconstruction of arm and hand function after ABPI is performed in a staged treatment fashion, making it suitable for CER.
Combining nerve surgery and secondary tendon transfers at various moments we can use single patient trial.
Methods
Prospective observational study
Exploiting treatment preferences to create and compare similar treatment
groups (CER);
Build a network of trauma centers specialized in treatment of ABPI
Outcome measures:
Minimal outcome set: COS-TBPI (Miller JHSE 2023): BraT (Hill 2017), BPI, Plasticity grade (Socolovsky JNS 2023), Donor site morbidity.
Minimal follow up 3 years
Timetable:
July25: building co-ops
October 25 Research protocol
December 25: Survey/Provider Profiling results
May 26: start inclusion CER