Brachial Plexus Injury-Adult-Current Concepts of the Treatment of Adult Brachial Plexus Injuries

Current Concepts of the Treatment of Adult Brachial Plexus Injuries

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The treatment of adult brachial plexus injuries has seen significant advancements in recent years, allowing for improved function in patients with these life-altering injuries. This review provides an overview of the current concepts in the treatment of these injuries, including timing, available treatment options, and outcomes. <br /><br />Patient evaluation is crucial in determining the appropriate treatment approach. Each patient is unique and may have different associated injuries and circumstances surrounding the injury. A detailed history and physical examination should be conducted to assess both motor and sensory components of the affected limb. Radiographic evaluation, including imaging of the cervical spine, shoulder, and extremity, is also important to assess for coexisting fractures or vascular injuries. Electrodiagnostic studies can confirm the diagnosis, localize the lesion, and define the severity of axon loss.<br /><br />Treatment options depend on the mechanism and type of injury. Nerve transfers, muscle transfers, tendon transfers, and arthrodesis can be used to restore function, depending on the specific injury and patient factors. It is crucial to restore elbow flexion, shoulder stability, and hand function, as these are key priorities for patients. Sensation restoration is also important for prehensile function and prevention of injuries.<br /><br />Overall, early intervention is ideal, but the optimal timing for surgery depends on the individual patient and injury. Successful outcomes are more likely when surgery is performed within 6 months of injury. However, innovative surgeons have challenged this dogma and have achieved good results with early surgical exploration and reconstruction.<br /><br />In conclusion, advancements in microsurgical techniques and a better understanding of nerve injury and repair have provided opportunities to improve function in patients with adult brachial plexus injuries. A multidisciplinary approach and individualized treatment plans are essential to achieve the best possible outcomes.

Keywords

treatment

adult brachial plexus injuries

advancements

function

patient evaluation

treatment options

outcomes

nerve injury

surgical exploration

microsurgical techniques