Abstract
We review our experience treating 335 adult patients with supraclavicular brachial plexus injuries over a 7-year period at the University of Southern Santa Catarina, in Brazil. Patients were categorized into 8 groups, according to functional deficits and roots injured: C5-C6, C5-C7, C5-C8 (T1 Hand), C5-T1 (T2 Hand), C8-T1, C7-T1, C6-T1, and total palsy. To restore function, nerve grafts, nerve transfers, and tendon and muscle transfers were employed. Patients with either upper- or lower-type partial injuries experienced considerable functional return. In total palsies, if a root was available for grafting, 90% of patients had elbow flexion restored, whereas this rate dropped to 50% if no roots were grafted and only nerve transfers performed. Pain resolution should be the first priority, and root exploration and grafting helped to decrease or eliminate pain complaints within a short time of surgery.
Highlights
Brachial plexus lesions are a tragic condition that usually affects young adults, with significant socioeconomic implications
Brachial plexus surgery still was approached with considerable pessimism
Between January 2002 and December 2008, 335 patients suffering from supraclavicular brachial plexus palsy underwent surgical repair
Summary
Brachial plexus lesions are a tragic condition that usually affects young adults, with significant socioeconomic implications. C5-C8 root injury (T1 Hand, n = 63) In addition to the shoulder and elbow flexion palsy, the teres major, latissimus dorsi and triceps all were paralyzed. C5-T1 root injury with partially preserved finger flexion and Horner’s sign (T2 Hand, n = 12) In these patients, the shoulder was completely paralyzed.
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