Post-traumatic brachial plexus paralysis: current management of reconstruction

• Published in: Current orthopaedics Vol. 15; no. 1; pp. 76 - 83
• Main Authors: Vekris, M.D., Soucacos, P.N.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-02-2001
• ISSN: 0268-0890; 1532-2068
• DOI: 10.1054/cuor.2001.0169

Post-traumatic brachial plexus paralysis is usually caused by high-velocity motor vehicle accidents that occur in the young productive population. The socio-economic impact is considerably high, since after the injury the patient faces either permanent disability of the paralysed extremity and/or a prolonged time of recuperation. The prognosis is grave if multiple root avulsions are present. The current management of these devastating injuries involves an early, aggressive microsurgical reconstruction of the brachial plexus, combining various neurotizations with intraplexus and extraplexus ipsilateral and contralateral nerve donors, with conventional or vascularized nerve grafts and secondary functional enhancement with vascularized and neurotized muscle transfers. This multistaged microsurgical approach if applied early offers, especially in young patients, satisfactory function, even in cases with multiple avulsions.