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Spinal Nerves: Plexus I

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...

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Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation

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Published on: June 13, 2025

Transclavicular approach for brachial plexus reconstruction.

Mary Zadnik¹, W Andrew Eglseder, Vladimir B Shur

¹R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.

Techniques in Hand & Upper Extremity Surgery

|June 6, 2008

Summary

The transclavicular approach offers improved surgical exposure and reduced time for brachial plexus injuries. This method, utilizing osteotomy or nonunion, demonstrated successful healing and minimal complications in patients.

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Area of Science:

Neurosurgery
Orthopedic Surgery
Trauma Surgery

Background:

Brachial plexus injuries can necessitate extensive surgical exposure.
The transclavicular approach is a potential surgical technique for these injuries.

Purpose of the Study:

To evaluate the efficacy and safety of the transclavicular approach for brachial plexus injuries.
To present a specific technique for the transclavicular approach using osteotomy.

Main Methods:

A retrospective review of 20 patients with brachial plexus injuries treated at a level 1 trauma center.
Surgical intervention using a transclavicular approach in 10 patients.
Specific techniques included osteotomy (5 patients) and utilizing established nonunion (5 patients).

Main Results:

All 10 patients undergoing the transclavicular approach experienced successful healing of osteotomies and nonunions.
No hardware-related complications were reported.
The approach facilitated exposure and decreased surgical time.

Conclusions:

The transclavicular approach is a viable and safe option for brachial plexus injuries requiring extensive exposure.
This technique offers benefits such as improved exposure, reduced surgical duration, and minimal risk.
Further research may explore its application in various brachial plexus injury scenarios.