Brachial Plexus Injuries

Treatment

A team approach to brachial plexus injury is key to successful recovery. At Mayo Clinic, a multidisciplinary team ensures that your treatment plan is customized for you and accounts for all aspects of your recovery.

Your treatment will depend on the type and severity of your brachial plexus injury. Treatment options may include:

• Initial "watch and wait." Some milder injuries will improve over several months, so your doctor may schedule regular appointments for three to six months to monitor your progress.
• Therapy. Even if your injury heals on its own, physical and occupational therapy are typically recommended to help you regain full function.
• Surgery. If there is no improvement within three to six months, or the injury is severe, surgery will be needed to improve nerve function.

Surgery

Surgery for brachial plexus injury should be performed by a skilled and experienced team. To prevent permanent nerve damage, surgery should occur within a few months of injury.

Mayo surgeons are highly skilled in all microsurgical techniques to make delicate repairs in the nerves, including:

Nerve transfer

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• Neurolysis — clearing scar tissue from the nerve
• Nerve graft — transplanting a nerve from the leg to reconnect damaged nerves
• Nerve transfer — sewing an adjacent, functioning nerve or part of a nerve into a nonfunctioning nerve in an attempt to restore function in a paralyzed muscle
• Free muscle transfer — transferring healthy muscles and nerves from the leg to the injured area to restore function to the arm


Muscle transfer

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• Capsule release — removing scar tissue and contractures to reduce pain and increase function in a joint
• Tendon transfer — shifting a functioning tendon to a new location to restore function
• Correction of the arm (osteotomy) — separating and reattaching bone to change the arm's alignment
• Joint fusion — permanently joining the ends of two bones to increase stability and strength in an injured joint

The goal of surgery for brachial plexus injury is to restore some function in your shoulder, elbow and hand. More than one surgery may be needed to regain additional function. Physical therapy and other treatments after surgery help to maximize your recovery.