Aims To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients.
Patients and Methods A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients’ injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion.
Results In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC.
Conclusion Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus.
Cite this article: Bone Joint J 2017;99-B:255–60.
- Polytrauma outcome
- Major trauma
- Multiple trauma
- Long term
- Upper extremity
- Brachial plexus lesion
C. Macke: Statistical analysis, Interpretation of the data, Writing and revision of the manuscript.
M. Winkelmann: Statistical analysis, Interpretation of the data, Writing and revision of the manuscript.
P. Mommsen: Interpretation of the data, Revision of the manuscript.
C. Probst: Study design, Interpretation of the data, Revision of the manuscript.
B. Zelle: Analysis of the data, Revision of the manuscript.
C. Krettek: Interpretation of the data, Revision of the manuscript.
C. Zeckey: Study design, Analysis and interpretation of the data, Writing and revision of the manuscript.
The authors gratefully thank Mr H. C Pape for the intellectual input to this manuscript. MW and CM contributed equally to this manuscript.
The authors received no pharmaceutical support for this study. Industrial support was supplied by Hannover Life Re. No direct or indirect financial support or other assets were transferred to the authors for this study.
All of the authors state that there are no competing financial interests.
Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but will be directed solely to a research fund, foundation, educational institution, or other nonprofit organisation with which one or more of the authors are associated.
This article was primary edited by R. Jeffery and first proof edited by G. Scott.
- Received February 1, 2016.
- Accepted September 2, 2016.
- ©2017 The British Editorial Society of Bone & Joint Surgery