Lacerations to the brachial plexus: surgical techniques and outcomes

The charts of patients with 201 brachial plexus elements sustaining operative lacerations and managed at Louisiana State University Health Sciences Center (LSUHSC) were reviewed retrospectively. Results for elements injured by sharp transections and undergoing suture repairs performed within 72 hr, as well as secondary suture and secondary graft repairs are documented. Similarly, results for secondary end-to-end suture anastomosis and secondary graft repairs for elements sustaining blunt transections are reviewed. Results for neurolysis, end-to-end suture anastomosis, and graft repairs for plexus elements in continuity despite the laceration injury are reviewed. Outcomes for the LSUHSC series of brachial plexus lacerations are one of the best of all LSUHSC plexus injuries, even for elements generally viewed as unfavorable for repair. Lesions in continuity with positive nerve action potentials (NAPs) had the best outcomes.