The brachial plexus is a system that comprises nerves which originate in the spinal cord and end in different muscle of the upper extremity. These nerves control movement of the innervated muscles. Under certain circumstances the brachial plexus can get damaged which consequently results in reversible or irreversible arm muscle functional loss. This anatomical structure is most commonly damaged due to car accidents, may be associated with sport injuries or affect babies during childbirth.
Diagnosing Brachial Plexus Injury
In order to confirm brachial plexus injury and damage, doctor evaluates patient's medical history and perform physical and neurological examination. It is essential to assess the severity of the injury and the extent of damage to the brachial plexus. Additional help is obtained from X-ray, MRI or CT scan of the injured shoulder. Electromyography (EMG) is a powerful tool that points to loss of muscle strength, if it has developed. And finally, nerve conduction study measures transmission of electrical signals through affected nerves and this way asses the extent of damage.
Brachial Plexus Injury Treatment
Treatment must start immediately in order to prevent further damage or complete loss of certain functions. One of the major factors that influences the success of treatment is a team approach. This type of injury requires a multidisciplinary team which customizes treatment and is of great importance for the recovery.
Treatment is individual and basically depends on the extent and severity of brachial plexus injury. Some patients are only monitored. This approach is applied in case of milder injuries that may improve on their own within several months. However, even if the injury heals spontaneously patients still require adequate physical and occupational therapy. These two will accelerate healing and restore all the lost functions. Patients who have not achieved full recovery after several moths (to be more precise after 6 months) with conservative treatment, require surgery. Surgery is also a treatment option in individuals who have had a severe injury accompanied by serious and immediate neurological deficits.
Brachial Plexus Injury Surgery
This type of surgery requires a well experienced professionals. A team of experts is involved. The goal of the surgery is to prevent permanent damage to the brachial plexus. The best results are achieved if one is operated within a few months after the injury.
In order to perform delicate repair surgeons use different approaches some of the following: neurolysis, nerve graft, nerve transfer, free muscle transfer, capsule release, tendon transfer, correction of the arm or joint fusion. Finally, after the surgery patients are obliged to participate in physical therapy in order to improve the overall recovery.