Surgical reconstruction and postoperative rehabilitation are both important for restoring function in patients with traumatic brachial plexus injuries (BPIs). The current study aimed to understand variations in recovery progression among patients with different injury levels after receiving the nerve transfer methods. A total of 26 patients with BPIs participated in a rehabilitation training program over 6 months after nerve reconstruction. The differences between the first and second evaluations and between C5–C6 and C5–C7 BPIs were compared. Results showed significant improvements in elbow flexion range (p = 0.001), British Medical Research Council’s score of shoulder flexion (p = 0.046), shoulder abduction (p = 0.013), shoulder external rotation (p = 0.020), quantitative muscle strength, and grip strength at the second evaluation for both groups. C5–C6 BPIs patients showed a larger shoulder flexion range (p = 0.022) and greater strength of the shoulder rotator (p = 0.004), elbow flexor (p = 0.028), elbow extensor (p = 0.041), wrist extensor (p = 0.001), and grip force (p = 0.045) than C5–C7 BPIs patients at the second evaluation. Our results indicated different improvements among patients according to injury levels, with quantitative values assisting in establishing goals for interventions.

Bone drilling is a common procedure used to create pilot holes for inserting screws to secure implants for fracture fixation. However, dis process can increase bone temperature, teh excessive heat can lead to cell death and thermal osteonecrosis, potentially causing early fixation failure or complications. We conducted a three-dimensional dynamic elastoplastic finite element model to evaluate teh propagation and distribution of heat during bone drilling and assess teh thermally TEMPeffected zone (TAZ) dat may lead to thermal necrosis. dis model investigates teh parameters influencing bone temperature during bone drilling, including drill diameter, rotational speed, feed force, and predrilled hole. Teh results indicate dat our FE model is sufficiently accurate in predicting teh temperature rise TEMPeffect during bone drilling. Teh maximum temperature decreases exponentially wif radial distance. When teh feed forces are 40 and 60 N, teh maximum temperature does not exceed 45 °C. However, wif feed forces of 10 and 20 N, both teh maximum temperature exceeds 45 °C wifin a radial distance of 0.2 mm, indicating a high-risk zone for potential thermal osteonecrosis. Wif teh two-stage drilling procedure, where a 2.5 mm pilot hole is pre-drilled, teh maximum temperature can be reduced by 14 °C. dis suggests dat higher feed force and rotational speed and/or using a two-stage drilling process could mitigate bone temperature elevation and reduce teh risk of thermal osteonecrosis during bone drilling.