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What is Traumatic Brachial Plexus Palsy?

Traumatic brachial plexus palsy refers to an acute injury to the network of nerves that control the central movement and sensation to the arm and hand.

The brachial plexus network is a complex set of intertwined nerves. This network begins at the neck and crosses the shoulder and upper chest into the armpit. It is susceptible to sudden damage usually due to a stretch or traction injury.

Injury to this network of nerves most often occurs when the arm is stretched or pulled. This can cause a loss of feeling and weakness in the hand, arm, or shoulder. Complete loss of sensation and movement in parts or all of the arm is also possible.

Characteristics and Clinical Presentation of Traumatic Brachial Plexus Palsy

Many injuries to the brachial plexus occur when the arm is pulled or stretched. Injuries can also occur during collision sports, falls, vehicle or motorcycle collisions, or gunshot or knife wounds. They may vary in severity, depending not only on the injury, but the amount of force the plexus receives from an external body. These injuries will vary greatly depending on severity.

Symptoms include:

  • Weakness or numbness
  • Loss of sensation
  • Paralysis
  • Pain, shocks or tingling

Getting a Diagnosis for Traumatic Brachial Plexus Palsy

A physical examination is central within an appropriate time frame to get the best possible prognosis. The longer the muscle is unable to receive input from the nerve, the less likely the muscle is to gain strength. Parsonage-Turner Syndrome is also a consideration as an atraumatic cause.  

Some injuries may not regain full function. Imaging tests such as X-rays to visualize bones of the neck, the hand, wrist, or arm will be conducted, in addition to MRIs for nerves, discs, ligaments, and bones, or CT scans to examine in greater detail the extent of the boney injury. A nerve conduction study will be requested.

Treatment Options for Traumatic Brachial Plexus Palsy

It is true that many injuries to the brachial plexus will recover on their own without surgical intervention. This is especially true if they are mild in nature. Studies have shown that nerve injuries that have the chance to heal on their own have a better outcome with regards to restoration of function.

If your surgeon decides your injury would benefit from healing on its own, they will monitor the injury and offer recommendations to optimize recovery.

Conservative Treatments

If the patient’s injury is expected to heal on its own or mostly, the surgeon may administer non-steroidal anti-inflammatories to relieve pain or utilize the expertise of a pain service physician.

Periodic physical examinations, nerve studies, and imaging tests will be ordered to monitor the injury’s progress. It is important to seek medical supervision with an experienced hand surgeon with a specialty in nerve damage, like Drs. Pruzansky, for the best possible prognosis.

Surgical Treatments

In the event that the injury will not heal on its own or fail to recover on their own, surgical intervention may be considered to improve function in the hand and arm. It is important to recognize that sometimes even a surgical procedure may not be able to restore the injured area to its pre-injury capabilities.

Surgical techniques depend on the severity of the injury. However, the most common procedure involves an incision made near the collarbone, above and/or below. Microscopes are utilized to repair and reconstruct and reconnect nerves the brachial plexus network.

Preventing Traumatic Brachial Plexus Palsy

Because most injuries of this nature are traumatic in nature, commonly sustained in an accident, they are difficult to prevent. Being aware of your surroundings and protecting your head, hands, and arms during a fall is important not only for nerve health. Protective sports gear, proper technique, and following safety guidelines for your activities are paramount.

Seeking medical supervision as soon as you notice that your hand, wrist, or arm may not be operating properly is extremely important.

Prognosis for Traumatic Brachial Plexus Palsy

Nerve generation is slow, and the rate of recovery is related to the degree of nerve injury. Some patients may not experience results for many months. Some or none of the pre-injury function may return to the arm following the recovery period. Complex reconstructive surgery may help.

Occupational therapy is vital to prevent stiffness and to create modifications to daily use of the arm to navigate new approaches to routine activities.

If You Believe You Have Traumatic Brachial Plexus Palsy, Contact HandSport Surgery Institute.

Please contact us as soon as possible to schedule an appointment with our talented team. People who have been hurt should be evaluated to try and prevent further injury and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.

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