Summary

  • Most commonly result from motor vehicle accidents, gunshot or stab wounds, contact sports accidents, or workplace accidents during heavy physical labor.
  • May involve the upper 2 or 3 nerve roots (partial injury) or all 5 nerve roots (complete injury). Partial and complete brachial plexus injuries can both be repaired successfully, but complete injuries require multiple major operations over the course of several years, while partial injuries can often be corrected in a single operation.
  • Complete injuries can be ruptures (roots still connected to the spinal cord) or avulsions (roots detached from the spinal cord). Although ruptures have traditionally been treated with direct nerve repair and grafting, recent approaches have tended to use nerve transfer techniques, which can be successfully applied to both ruptures and avulsions.
  • An injury that does not resolve within a few days will often require major surgical reconstruction. The speed of nerve regeneration after spontaneous recovery or nerve repair is about 1 mm per day (1 inch per month).
  • Given the time frame to permanent paralysis (about 1 year), surgical repair is best carried out by 4 to 6 months after injury.

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