The failed adult traumatic brachial plexus reconstruction

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Rehabilitation Medicine

Background:

• Traumatic adult brachial plexus injuries frequently result in immediate and significant upper limb dysfunction.
• Specialized, multidisciplinary treatment offers a good prognosis for achieving a functional helper arm.
• Setting realistic patient expectations through open communication is crucial for successful outcomes.

Purpose of the Study:

• To review late treatment strategies for managing failed primary reconstructions of traumatic adult brachial plexus injuries.
• To provide an overview of salvage options when initial surgical reconstruction does not meet functional goals.

Main Methods:

• This is a review article discussing established and emerging late treatment options.
• The review synthesizes information on surgical techniques and their indications for secondary reconstruction.
• Focus is placed on managing outcomes after primary brachial plexus repair failure.

Main Results:

• Late treatment options for failed brachial plexus reconstruction are diverse and patient-specific.
• Effective management may involve tendon transfers, joint fusions, free functioning muscle transfers, or prosthetics.
• Meticulous surgical technique, pain control, and adherence to indications are vital for optimizing results.

Conclusions:

• Failed primary reconstruction of traumatic adult brachial plexus injuries necessitates consideration of alternative late treatment strategies.
• A range of reconstructive options exists to improve function in cases of initial treatment failure.
• Pre-operative discussion of potential alternative treatments is essential for managing patient expectations.