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J Am Acad Orthop Surg, Vol 13, No 6, October 2005, 382-396.
© 2005 the American Academy of Orthopaedic Surgeons
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Adult Traumatic Brachial Plexus Injuries

Alexander Y. Shin, MD, Robert J. Spinner, MD, Scott P. Steinmann, MD and Allen T. Bishop, MD

Dr. Shin is Associate Professor, Department of Orthopaedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN. Dr. Spinner is Associate Professor, Department of Neurosurgery and Department of Orthopaedic Surgery, Division of Hand Surgery, Mayo Clinic. Dr. Steinmann is Assistant Professor, Department of Orthopaedic Surgery, Mayo Clinic. Dr. Bishop is Professor, Department of Orthopaedic Surgery, Mayo Clinic.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Shin, Dr. Spinner, Dr. Steinmann, and Dr. Bishop.

Reprint requests: Dr. Shin, Mayo Clinic, E14A, 200 1st Street SW, Rochester, MN 55905.

Adult traumatic brachial plexus injuries are devastating, and they are occurring with increasing frequency. Patient evaluation consists of a focused assessment of upper extremity sensory and motor function, radiologic studies, and, most important, preoperative and intraoperative electrodiagnostic studies. The critical concepts in surgical treatment are patient selection as well as the timing and prioritizing of restoration of function. Surgical techniques include neurolysis, nerve grafting, neurotization, and free muscle transfer. Results are variable, but increased knowledge of nerve injury and repair, as well as advances in microsurgical techniques, allow not only restoration of elbow flexion and shoulder abduction but also of useful prehension of the hand in some patients.






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Copyright © 2005 by the American Academy of Orthopaedic Surgeons.