Information for brachial plexus injuries

The brachial plexus is a network of nerves that conduct signals from the spine to the shoulder, arm and hand. Brachial plexus injuries are caused by damage to those nerves. A brachial plexus injury occurs when these nerves are stretched or in the most serious cases torn. This usually happens when your shoulder is pressed down forcefully while your head is pushed up and away from that shoulder.

Symptoms may include a limp or paralyzed arm; lack of muscle control in the arm, hand or wrist; and a lack of feeling or sensation in the arm or hand. For those who do not recover, the treatment for brachial plexus injuries includes physical therapy and surgery.

Surgical treatment

The purpose of surgery is to release the scar around the nerves and repair the completely severed nerve with nerve grafts and/or nerve transfers. Usually at best there is limited return of function in only certain muscles after 6 to 12 months.

After surgery

After surgery, a dressing will be applied on the shoulder and possibly leg cuts incision (in case the graft was taken from the leg). You should leave this secured in place for 3 days following surgery. You can wet the stitches afterward. You will be fitted with a shoulder sling which you should wear all the time for 3 weeks. You should restart your physiotherapy as aggressive as before after removing the sling. Your stitches can be removed about 10-14 days after surgery. You will have a follow-up in about 8 weeks. Typically patients will have same amount of pain after surgery and should continue their pain medications.