Brachial Plexus Injuries and Repair

Summary

Closed traction injuries of the brachial plexus are always crippling. For somebody who has nothing, a little is a lot. The healing process, surgeon, patient, and the rehabilitation program are the main factors influencing the outcome of the treatment. The healing process involves age, degree, extent and location of injury, and the time interval between injury and surgery. The surgeon can directly influ-ence the overall outcome, although assurance of functional restoration is unpredictable. A thorough knowledge of the anatomy of the brachial plexus, classification of the brachial plexus injury (BPI), types of brachial plexus injury, timing of surgery, techniques for nerve repair, postoperative management and rehabilitation, and familiarity with conventional hand reconstruction for palliative reconstruction for sequelae deformities are all basic requirements for the brachial plexus reconstructive surgeon. The patient's desire and cooperation are also important determining factors, especially for patients who receive nerve transfer. Microneurovascular transfer of functioning free muscles adds additional techniques to enhance the results. Throughout the understanding of the complexity of nerve and nerve reconstruction, outcome for the patients with brachial plexus injury and surgeons is more optimistic now.