A Simple Test of Self-care to Record and Evaluate the Outcome of Nerve Reconstruction in Extended Partial Plexus Injuries

Abstract

To evaluate a new functional task (sleeve-buttoning) as a measure of segmental upper extremity recovery after C5–C7 brachial plexus reconstruction.

A total of 18 male patients (mean age 27 years) with upper brachial plexus (C5–C7) injuries who underwent nerve reconstruction at least 2 years prior were evaluated using a sleeve-buttoning task (buttoning both shirt cuffs). The task was also performed by 42 healthy controls (aged 20–40 years). The primary outcome was the total time to button both cuffs. Patient completion times were compared with those of controls and categorized as excellent, good, or fair based on relative performance. Patients unable to complete the task were excluded from analysis.

The mean completion time in controls was 21.9 ± 15.9 seconds. The patient group's mean time was 30.7 seconds (median 17; range 9–111 seconds). Performance was classified as excellent in 12 patients, good in 5, and fair in 1 patient (who took 111 seconds). 12 of the 18 patients could complete the task quicker than the control mean, whereas 1 patient had a markedly prolonged time indicating severely impaired function. The sleeve-buttoning task distinguished a wide range of functional outcomes among the patients.

The sleeve-buttoning task is a feasible and effective measure for differentiating levels of upper extremity functional recovery after brachial plexus reconstruction. This simple task provides an objective assessment of segmental upper extremity function. It is intended to assess functional return rather than to directly measure surgical success.