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Brachial plexus injury.

A R Hudson, I Dommisse

Canadian Medical Association Journal

|November 19, 1977

Summary

This summary is machine-generated.

This case study details successful surgical repair of a severe brachial plexus injury using sural nerve grafts. The treatment led to significant recovery of motor and sensory function, demonstrating the efficacy of nerve grafting for complex injuries.

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Area of Science:

Neurosurgery
Traumatology
Regenerative Medicine

Background:

Brachial plexus injuries can result from severe trauma, leading to significant functional deficits.
Assessing nerve continuity in acute brachial plexus injuries is challenging, often necessitating delayed surgical intervention.
Total brachial plexus palsy presents a complex reconstructive problem requiring specialized surgical techniques.

Observation:

A 28-year-old male sustained a shotgun injury to the neck, causing total brachial plexus palsy.
Initial management involved secondary repair due to difficulties in assessing nerve continuity.
The musculocutaneous nerve was the sole element without evidence of nerve continuity after nine weeks.

Findings:

Sural nerve autografts were utilized to bridge the gap in the musculocutaneous nerve.

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Significant return of both sensory and motor function was observed by four months post-surgery.

By 18 months, sensation returned to the autonomous zones of the median and ulnar nerves, with good muscle power recovery.

Implications:

Nerve grafting with sural nerve autografts is a viable option for reconstructing complex brachial plexus injuries.
Delayed surgical repair can lead to substantial functional recovery in cases of total brachial plexus palsy.
This case highlights the potential for significant neurological recovery following reconstructive surgery for severe peripheral nerve trauma.