Brachial Plexus Birth Palsy-Brachial Plexus: Pediatric and Traumatic Overview

Brachial Plexus: Pediatric and Traumatic Overview

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Chapter 18 of the document discusses the anatomy, evaluation, and treatment of brachial plexus injuries in pediatric and adult patients. The brachial plexus is a network of nerves that control movement and sensation in the upper extremities. It typically arises from the C5 to T1 nerve roots, but anatomical variations are common. The plexus is divided into five segments: roots, trunks, divisions, cords, and nerves. The nerves arising from the brachial plexus supply various muscles and areas of the upper extremities.<br /><br />In pediatric patients, brachial plexus birth palsy (BPBP) refers to an injury sustained during birth that leads to upper extremity paralysis. Risk factors for BPBP include macrosomia, difficult or prolonged labor, shoulder dystocia, and vacuum or forceps-assisted delivery. The severity of the injury can range from neurapraxia to complete nerve avulsion. Prognostic indicators for recovery include the presence of a Horner syndrome, elevated hemidiaphragm, scapular winging, and absence of trapezius function. Treatment options include observation, physical therapy, and surgical intervention.<br /><br />In adult patients, brachial plexus injuries are typically caused by trauma. Diagnosis involves a thorough clinical examination, including motor and sensory assessments. Diagnostic imaging and electrophysiological studies may also be used to aid in the diagnosis. Treatment depends on the extent and type of injury and may include immediate or delayed reconstruction, tendon transfers, or nerve transfers. The goal of treatment is to restore motor function and improve quality of life.<br /><br />Secondary deformities, such as joint dysplasia and muscle imbalance, may occur in both pediatric and adult patients with brachial plexus injuries. These deformities can be addressed through various surgical interventions, including tendon transfers and osteotomies.<br /><br />Overall, the chapter provides an overview of the anatomy, evaluation, and treatment options for brachial plexus injuries in both pediatric and adult patients. It aims to guide clinicians in diagnosing and managing these complex injuries.

Keywords

brachial plexus injuries

anatomy

evaluation

treatment

pediatric patients

adult patients

brachial plexus birth palsy

neurapraxia

nerve avulsion

prognostic indicators