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Brachial Plexus Injuries


Introduction

Brachial plexus injuries are devastating injuries that result in partial or complete loss of motor function and/or sensation of the involved upper extremity. Motor vehicle accidents account for the majority of cases and most of these involve motorcycles (reported as high as 84%).(Choi 1997). The overall incidence of injury to the brachial plexus from motor vehicle accidents ranges from 0.67 to 1.3%, but increases to 4.2% in patients after motorcycle accidents.(Midha 1997). The next most common mechanisms include pedestrian/motor vehicle accidents, industrial accidents and gunshot wounds. Lower velocity injuries may also result in brachial plexus palsies and can occur from bicycling, skiing, or falling from a height or down stairs. These patients are young males in as many as 90% of cases.(Midha 1997). (Terzis 2000)

This chapter will review the history of brachial plexus surgery and the development of current surgical management. The mechanisms, diagnosis, and work-up of plexus injuries will be discussed. Finally, management options, surgical techniques, and postoperative management will be described.