Adult traumatic brachial plexus injuries are devastating life-altering injuries occurring with increasing frequency. Evaluation includes a detailed physical examination and radiologic and electrodiagnostic studies. Critical concepts in surgical management include knowledge of injury patterns, timing of surgery, prioritization in restoration of function, and management of patient expectations. Options for treatment include neurolysis, nerve grafting, or nerve transfers and should be generally performed within 6 months of injury. The use of free functioning muscle transfers can improve function both in the acute and late setting. Modern patient-specific management can often permit consistent restoration of elbow flexion and shoulder stability with the potential of prehension of the hand. Understanding the basic concepts of management of this injury is essential for all orthopaedic surgeons who treat trauma patients.
From the Mayo Clinic, Phoenix, AZ (Dr. Noland), and the Mayo Clinic, Rochester, MN (Dr. Bishop, Dr. Spinner, and Dr. Shin).
Dr. Noland or an immediate family member serves as a paid consultant to ExoToe LLC, Foot and Ankle Orthopedics, and Husband's company. Dr. Spinner or an immediate family member serves as a paid consultant to Mayo Medical Ventures. Dr. Shin or an immediate family member has received IP royalties from Mayo Medical Ventures and Trimed. Neither Dr. Bishop nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.