Brachial plexus injuries in adults

Abstract

The loss of upper extremity function following a traumatic brachial plexus injury causes devastating functional deficits that require complex surgical reconstruction. Because of advances and innovations in surgical techniques, it is now possible to reliably restore elbow flexion and shoulder stability, provided intervention is prompt. Recently, innovations have provided additional surgical reconstructive options that can be expected to improve functional outcomes. For example, methods are available that may, at times, restore basic grasp function in patients with lower plexus rupture or avulsion. Surgeons from all disciplines must be cognizant of these new possibilities and seek out additional training or partnerships across specialty boundaries to provide the best possible care in these devastating injuries. In many such reconstructive schemes, nerve transfer from multiple intraand extraplexal donor nerves and microvascular transfer of functioning free muscles to the paralyzed limb are integral parts of the total reconstructive plan. The complexity and rigor of these procedures for both