The effects of amputation on functioning, satisfaction and health-related quality of life of adults with brachial plexus injury; a scoping review

Brachial plexus injuries (BPI) significantly impact Health-Related Quality of Life (HRQoL) through limb malfunctioning, neuropathic and glenohumeral traction pain. Amputation emerges as a final intervention to alleviate traction pain, or eliminate a flail limb. This scoping review reveals insights on functioning, HRQoL and satisfaction of individuals with BPI and amputation, using the International Classification of Functioning, Disability and Health (ICF). A literature search was conducted using the Cochrane database, PubMed, EMBASE, CINAHL and Web of Science for articles that reported HRQoL and/or functioning in adults with BPI who underwent amputation. Outcomes reflected ICF-domains body function and structure, activities and participation. Twenty articles, mostly case reports and retrospective studies, reported on less pain, no hindrance of a flail limb anymore, less anxiety and depression, more energy and less fatigue post-amputation (ICF body functions/structures), with less limitations in daily activities and more social interaction (ICF activities/participation). Individuals reported being satisfied with their decision to amputate. Downsides were scarcely reported. Current literature supports that amputation may improve HRQoL and functioning in individuals with BPI, more research is needed however. Amputation is a last-resort surgical treatment in individuals with a brachial plexus injury which might alleviate pain and relieve individuals from their nonfunctional limbAmputation of an affected limb seems to be a viable treatment option leading to improved functioning, Health-Related Quality of Life and satisfactionThe Hippocratic oath (do good, and do no harm) may also apply to amputation as a treatment option Amputation is a last-resort surgical treatment in individuals with a brachial plexus injury which might alleviate pain and relieve individuals from their nonfunctional limb Amputation of an affected limb seems to be a viable treatment option leading to improved functioning, Health-Related Quality of Life and satisfaction The Hippocratic oath (do good, and do no harm) may also apply to amputation as a treatment option