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[Traumatic lesions of the brachial plexus]
A C Ferreira1, M F Henriques, F Batista
1Serviço de Cirurgia Plástica, Reconstrutiva e Maxilo Facial, Hospital de Santa Maria, Lisboa.
Acta Medica Portuguesa
|May 6, 1998
Summary
Recent advances in brachial plexus lesion treatment utilize microsurgery and a multidisciplinary approach. Early diagnosis and timely intervention, including nerve grafting and physiotherapy, are crucial for optimal outcomes in these injuries.
Area of Science:
- Neurology
- Microsurgery
- Regenerative Medicine
Context:
- Brachial plexus lesions predominantly affect young males, often due to motorcycle accidents.
- Historically, fragmented specialist care lacked a unified approach.
- Advances in anatomy, histology, and nerve regeneration physiology underpin modern treatment.
Purpose:
- To review the advancements in diagnosing and treating brachial plexus lesions.
- To highlight the importance of a multidisciplinary approach and microsurgical techniques.
- To discuss various surgical strategies, including nerve grafting and neurotization.
Summary:
- Diagnosis relies on clinical analysis, supported by electromyography, cervical myelography, ultrasonography, and magnetic resonance imaging.
- Microsurgery, particularly nerve grafting, is central to treatment for infra-ganglion lesions.
- For supra-ganglion lesions, neurotization using accessory spinal nerve, cervical plexus branches, or intercostal nerves is employed, prioritizing proximal muscle reinnervation.
Impact:
- Improved surgical outcomes through microsurgical techniques and nerve grafts.
- Established the critical role of physiotherapy and early therapeutic decisions.
- Enhanced prognosis and functional recovery for patients with brachial plexus injuries.