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Management of Adult Brachial Plexus Injuries

Brachial plexus injuries comprise approximately one third of all peripheral nerve injuries and are seen in just more than 1% of patients presenting to a trauma facility. They usually affect younger patients, with a median age of 34. Because of the association of such injuries with violent trauma and contact sports, males are affected more frequently than females. By the same line of reasoning, they are also often associated with injuries in other organ systems that are life-threatening. It was estimated that as many as 80% of patients with severe traumatic brachial plexopathy had multiple trauma to the head and skeletal system. Hence, there can be a delay in the diagnosis and treatment of…

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 Brachial Plexus

It is possible for the brachial plexus to be injured at the level of the cervical nerve roots or trunks in the neck, causing a syndrome of neurological deficits and clinical features. The most common injuries are Erb’s palsy, Klumpke’s palsy and Horner’s syndrome. Brachial plexus injuries are rare...

Articles of Interest

Brachial plexus injuries

In adults, a brachial plexus injury usually is caused by a trauma that causes a forced and sudden widening of the head-shoulder angle or the arm-trunk angle. Although this situation may occur in a wide spectrum of traumatic settings, it is most frequently encountered in road traffic accidents and, in particular, motorcycle accidents.

Brachial Plexus Injury in Adults

Brachial plexus injury (BPI) is a severe peripheral nerve injury affecting upper extremities, causing functional damage and physical disability. The most common cause of adult BPI is a traffic accident, and the incidence has steadily increased since the 1980s. BPIs can be divided into three types; preganglionic lesion, postganglionic lesion, and a combination of both. Whether the continuation of the root and the spinal cord is preserved is a critical factor in determining the treatment strategy.

Brachial Plexus Palsy: Pathophysiology, Diagnosis, and Management

Brachial plexus injuries were first described and documented in the late 1700s by William Smellie, a Scottish obstetrician. It wasn’t until the late 1800s, however, that a French neurologist, Guillaume Duchenne, coined the term obstetric palsy and described the mechanism for brachial plexus injury.

Brachial plexus trauma: the morbidity of hemidiaphragmatic paralysis

Brachial plexus injuries can be traumatic (gunshot wounds, lacerations, stretch/contusion and avulsion injuries) or non-traumatic in aetiology (supraclavicular brachial plexus nerve block, subclavian vein catheterisation, cardiac surgeries, or obstetric complications such as birth palsy).

Early Referral in Brachial Plexus Injury: An Ethical Obligation

Traumatic brachial plexus injuries (TBPIs) are debilitating and life-altering. Delayed referral to a brachial plexus surgeon (BPS) impacts reconstructive options and limits recovery, potentially compromising a patient’s lifelong functional status.

How to approach brachial plexus examination...

Examining a patient with brachial plexus injury may appear as a daunting task and this is made worse by being watched and questioned at the same time. Whilst there are over 50 named muscles to be tested, it is not practical (and there is not enough time in FRCS exam) to allow you to examine every single muscle in the upper limb. You then have to rely on pattern recognition.

Stingers/Brachial Plexus Injuries

The spinal cord extends from the base of the brain down the neck; large nerves branch off the spinal cord along its course. When one or more of these nerves are stretched or pinched, this mild injury to the nerves causes tingling and numbness in the arm and fingers; some athletes notice weakness in their arm as well. The terms “stinger” and “burner” are two terms sometimes used to describe this stretched or pinched condition. It can get stretched by pulling his head away from his shoulder. The nerves can get pinched when the head is forced towards the shoulder. These injuries are fairly common especially in football players, wrestlers and divers.

Traumatic Bilateral Brachial Plexus Injury

Brachial plexus injuries are uncommon, with a prevalence of 1.2% in multi-trauma patients.

Treatment Options for Brachial Plexus Injuries

Over the last three decades the operative techniques for brachial plexus injuries have steadily improved. However, the rate of progress now seems to have slowed down. New hopes have arisen through modern scientific studies and research on the pathophysiology of nervous tissue, pharmaceutical research on chemical factors that facilitate nerve growth, and biological research on synthetic nerve grafts as well as on the repair of avulsed nerve roots in the spinal cord marrow.

Resources

Traumatic Brachial Plexus Injury Group

This is a website created by and for adults who have a Trauma Brachial Plexus Injury (TBPI) The purpose of this much needed website is to supply information and support to adults coping with a TBPI and to help achieve a better understanding of the impact these injuries may have on the individual and their fami

National Association for Bikers with a Disability

The NABD offers and advice for disabled people on all aspects of motorcycling and related issues including; adaptations to mopeds, motorcycles, scooters, motorcycle/sidecar combinations, trikes and quad-cycles, insurance, licensing, trike riding, VAT exemptions for disabled riders, legal issues, rider training, adaptations to protective clothing and safety equipment; and any other issues relating to motorcycling for people with disabilities.