Transclavicular approach for brachial plexus reconstruction

Brachial plexus injuries requiring extensive exposure might benefit from a transclavicular approach. At a level 1 trauma center, 20 patients underwent surgical intervention for brachial plexus injuries, 10 via a transclavicular approach. For 5 patients, the transclavicular approach was accomplished through osteotomy with a technique presented herein, and for the other 5, through an established nonunion. All osteotomies and nonunions healed. No hardware-related complications occurred. We think that in the appropriate setting, a transclavicular approach facilitates exposure, decreases surgical time, and is associated with minimal risk.