Brachial Plexus Injury

A brachial plexus injury typically arises from complications during birth. The brachial plexus are a group of nerves located near the neck and shoulder. “Brachial” refers to arm and “plexus” refers to network. This group of nerves conducts signals from the spine to the hand, arm, and shoulder of the coordinating side of the body. In rare cases, a condition known as Parsonage-Turner syndrome may cause brachial plexus injury without any visible damage.

Causes of Brachial Plexus Injury

A brachial plexus injury may be the result of:

Classifying a Brachial Plexus Injury

There are varying levels of brachial plexus injury. Some types of brachial plexus injury are more severe than others, making treatment more difficult. A brachial plexus injury is classified by defining the nature and orientation of nerve damage. In all cases, it is important to begin treatment for a brachial plexus injury as soon as possible.

The basic forms of brachial plexus injury can be classified as:

Signs of Brachial Plexus Injury

The following symptoms may indicate a brachial plexus injury:

Treatment Options for Infants

Depending on the exact type of brachial plexus injury, the patient’s treatment needs may vary. A neuropraxia injury should not require extensive medical attention. Neuropraxia injuries typically heal on their own, within 3 to 6 months. An infant’s ability to bend the affected arm at the elbow by 3 months of age is a good indication of future recovery. Infants with neuroma injuries are also likely to recover, but may require surgery or physical therapy to help with the healing process.

Rupture and avulsion injuries are unpromising. The chances of full recovery are diminished. Both severe types of brachial plexus injury require surgery and physical therapy. The infant should receive surgery as soon as possible. Surgical options include external neurolysis, nerve grafting, and neurotization. Physical therapy is important for the continued recovery of the infant. Actions such as raising the arm, grasping small objects, and bending the wrist will be practiced.

Effects of Brachial Plexus Injury

A brachial plexus injury may result in permanent damage involving:

 

Sources:

“Brachial Plexus Injury After Shoulder Dystocia.” OBG Management Jan. 2012: 52. Academic OneFile. Web. 9 July 2012.
Hems, Tim. “Nerve Transfers For Traumatic Brachial Plexus Injury: Advantages And Problems.” Journal of Hand and Microsurgery 3.1 (2011): 6-10. Web. 9 July 2012.
Jilao Fan, et al. “Long-Term Outcomes Of Triangle Tilt Surgery For Obstetric Brachial Plexus Injury.” Pediatric Surgery International 26.4 (2010): 393-399. MEDLINE with Full Text. Web. 9 July 2012.
Johannes A Van Der Sluijs, et al. “Early Effects Of Muscle Atrophy On Shoulder Joint Development In Infants With Unilateral Birth Brachial Plexus Injury.” Developmental Medicine and Child Neurology 53.2 (2011): 173-178. MEDLINE with Full Text. Web. 9 July 2012.
Laska, Lewis. “12 lb, 7 oz Baby, Brachial Plexus Injury.” OBG Management Apr. 2012: 44. Academic OneFile. Web. 9 July 2012.