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Chapter 4 Surgical Treatment of Brachial Plexus Injury

Publication at Third Faculty of Medicine |
2017

Abstract

In recent years, brachial plexus injury has been attracting increasing attention, partly because of an increasing incidence arising out of higher survival rates for patients after polytrauma. Brachial plexus injury is one of the hardest and most mutilating injuries.

Owing to advances in microsurgical techniques, we can achieve success in restoring motor function for these patients. The purpose of this chapter is to introduce the reader with various microsurgical techniques, including nerve fascicle transfers and end-to-side neurorrhaphy (ETSN), which can be used for brachial plexus reconstruction based on personal experience with 1130 nerve reconstructions performed by the first author (PH) between 1993 and 2017.

Another goal of brachial plexus surgery is the resolution of severe intractable pain which can develop in up to 20% of cases. Dorsal root entry zone (DREZ) thermocoagulation is a very effective method for treatment of severe neuropathic pain.