Evidence map›Paper›PMID 33140117›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2021

Surgical management of pediatric patients with peripheral nerve and plexus lesions caused by stray bullets.

Fernando Guedes, Gabriel Elias Sanches, Nathalia Novaes, Amanda Guimarães Ferreira, Francisco Torrão

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Ballistic peripheral nerve injuries: basic concepts, controversies, and proposal for a management strategy.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Fernando GuedesPeripheral Nerve Unit, Division of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of the State of Rio de Janeiro (UNIRIO), 775 Mariz e Barros Street, Rio de Janeiro, RJ, 20270-901, Brazil. neuroguedes@yahoo.com.br.ORCID 0000-0003-4149-4783
Gabriel Elias SanchesPeripheral Nerve Unit, Division of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of the State of Rio de Janeiro (UNIRIO), 775 Mariz e Barros Street, Rio de Janeiro, RJ, 20270-901, Brazil.ORCID 0000-0002-3769-3678
Nathalia NovaesPeripheral Nerve Unit, Division of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of the State of Rio de Janeiro (UNIRIO), 775 Mariz e Barros Street, Rio de Janeiro, RJ, 20270-901, Brazil.ORCID 0000-0003-4683-867X
Amanda Guimarães FerreiraPeripheral Nerve Unit, Division of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of the State of Rio de Janeiro (UNIRIO), 775 Mariz e Barros Street, Rio de Janeiro, RJ, 20270-901, Brazil.ORCID 0000-0003-3906-1815
Francisco TorrãoPeripheral Nerve Unit, Division of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of the State of Rio de Janeiro (UNIRIO), 775 Mariz e Barros Street, Rio de Janeiro, RJ, 20270-901, Brazil.ORCID 0000-0002-3981-3549

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChildren and adolescents are frequent victims of gunshot wounds (GSW), either by direct intent or accidentaly. Lesions caused by stray bullets represent a specific type of accidental GSW and are usually associated with urban violence or aerial firing. We thereby present a series of surgically treated pediatric patients with peripheral nerve and brachial plexus lesions caused by stray bullets, referring to their clinical presentation, surgical procedures, and outcomes.

methodsRetrospective study of a series of seven pediatric patients treated from 2012 to 2019 for nerve and/or plexus lesions caused by stray bullets at the Peripheral Nerve Unit of the Division of Neurosurgery of Gaffrée e Guinle University Hospital (HUGG). We used the Visual Analog Scale (VAS) to evaluate pain distress and the British Medical Research Council grading system (BMRC) to assess muscle strength.

resultsPatients' ages ranged from 6 to 17 years old (median of 16), and two were female. All presented preoperatively with intense pain, with a median VAS of 9 (range 7 to 10), and six also had neurological deficits. External neurolysis was conducted in all cases, whereas reconstruction with grafts was needed in four patients. All experienced improvement of pain, and those with motor deficits also experienced some level of recovery.

conclusionPediatric patients who endure lesions by stray bullets appear to present with debilitating pain, and often with motor deficits. Multidisciplinary management comprising of surgical treatment and physical and occupational therapy may ameliorate symptoms and improve quality of life, as young patients usually fare better after surgery.

Indexed as

Brachial PlexusNerve TransferWounds, GunshotAdolescentChildFemaleHumansQuality of LifeRetrospective StudiesTreatment OutcomeGunshot woundsPediatricsPeripheral nervous systemStray bullets

Identifiers

PMID33140117

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.