Adult traumatic brachial plexus injuries: advances and current updates.
Jean-Noel Goubier1,2,3, Bruno Battiston4, Joaquim Casanas5
1Brachial Plexus and Nerve Surgery Institute, Paris, France.
The Journal of Hand Surgery, European Volume
|February 17, 2024
Summary
Brachial plexus injuries can be treated with nerve grafting, tendon transfer, or joint fusion. Newer nerve transfer techniques offer improved upper limb function, especially in severe cases where grafting isn't possible.
Area of Science:
- Orthopedics
- Neurosurgery
- Reconstructive Surgery
Background:
- Brachial plexus injuries significantly impair upper limb function.
- Established treatments include nerve grafting, tendon transfer, and joint fusion.
- Emerging techniques offer expanded reconstructive options.
Purpose of the Study:
- To present current surgical techniques for treating brachial plexus injuries.
- To highlight the role of nerve transfers in restoring function.
- To discuss diagnostic and evaluative methods in brachial plexus reconstruction.
Main Methods:
- Review of current surgical techniques for brachial plexus injury.
- Description of nerve transfer procedures for total root avulsions and partial injuries.
- Emphasis on intraoperative electrical stimulation for precise diagnosis.
- Discussion of postoperative outcome measurement for technique evaluation.
Main Results:
- Nerve grafting, tendon transfer, and joint fusion are standard treatments.
- Nerve transfers provide crucial functional restoration in total root avulsions.
- Nerve transfers significantly enhance function in partial brachial plexus injuries.
- Intraoperative electrical stimulation aids in accurate nerve identification and fascicle selection.
Conclusions:
- Nerve transfers represent a valuable tool in brachial plexus reconstruction.
- These techniques can restore shoulder, elbow, wrist, and hand function.
- Accurate diagnosis and outcome measurement are key to successful treatment.
