A brachial plexus is a group of nerves which originates from the spinal cord. Nerves in the brachial plexus have their own specific function, such as powering muscles or carrying sensory information from the hand to the brain. These group of nerves is responsible for movement and sensation of the arm and hand. Traumatic brachial plexus injury involves sudden damage to these group of nerves which can lead to weakness, loss of movement in the shoulder, hand or the arm and loss of sensation. Brachial plexus starts from the neck and crosses the upper chest to the armpit. Injury to this group of nerves generally occurs when the arm is forcibly pulled or stretched. Brachial plexus injuries are very serious and can cause partial or complete loss of sensation or function of the involved upper extremity. Mild brachial plexus injuries generally heal without treatment whereas severe injuries may require surgery to regain function of the arm or hand.
Brachial plexus injury occurs when the shoulder is forced down while the neck stretches up and away from the injured shoulder. The nerves in the lower area are more likely to be injured when the arm is forced above the head. Brachial plexus injuries can occur in several following ways:-
Rigorous sports activity: – People who play contact or rigorous sports are more prone to brachial plexus injury as the nerves in the brachial plexus get stretched beyond their limit during collisions with other players.
Radiation: – Harmful radiation rays can also damage the brachial plexus. People who had radiation treatment are prone to brachial plexus injury.
Inflammation: – Inflammation can also cause damage to the brachial plexus.
Tumors: – Cancerous or noncancerous tumors can grow in the brachial plexus and put pressure on the brachial plexus or can spread to the nerves which can lead to damage of brachial plexus.
Trauma: – Trauma such as accident or fall can also result in brachial plexus injuries.
Diagnosis: – To diagnose the exact cause and treatment for the patients the doctor conducts a series of tests to help diagnose the extent and severity of a brachial plexus injury:-
Electromyography (EMG):- Electromyography evaluates the electrical activity of the muscles when they are at rest and when contracted. This test is performed by inserting a needle electrode through the skin into various muscles.
Nerve conduction study: – Nerve conduction is usually performed as the part of Electromyography by measuring the speed of conduction in the patient’s nerve when a small current passes through the nerve. This test provides information about the function of the nerve.
Magnetic resonance imaging (MRI):- MRI is performed using powerful magnets and radio waves. MRI show the extent of the damage caused by a brachial plexus injury and helps in evaluating the status of arteries for reconstruction.
Angiogram: – In case if the doctor suspects that the blood vessels feeding the arm might be injured, angiogram is suggested to check the condition of the blood vessels.
Treatment for brachial plexus injury depends on several factors such as the type of the injury, severity of the injury, causes of the injury and the length of time since the injury exists. In case if only the nerves are stretched it may recover without any treatment. Doctor generally recommends physical therapy to patients for the joints and muscles to working properly and maintain the range of the motion and preventing the stiffness in the joints. Surgical procedure is performed for nerves that have surrounding scar tissue or that have been cut or torn. There are different types of the surgery to treat brachial plexus injury. The type of surgery recommended to patients depends on the condition of the patient.
Nerve Graft: – In nerve graft surgery the damaged part of the brachial plexus is removed and replaced with sections of the nerves which are harvested from other part of the patient’s body. Nerve graft surgery helps in restoring the functions of the arms.
Muscle Transfer: – Muscle transfer is a surgical procedure performed to remove the less important tendons or muscles from another part of the body such as thighs and transfers it to the arm. These tendons or muscles are then reconnects to the nerves and blood vessels supplying the muscle.
Nerve Transfer: – In case if the nerve root has been torn from the spinal cord, surgeons take less important nerve which is attached to the spinal cord and connect it to the nerve which is no longer attached to the spinal cord. Surgeons may also perform this technique to speed up the recovery rather than repair the muscle. After the transfer, the nerve tissues grow slowly and it can take up to several years.
Brachial plexus surgery is a complicated procedure which is why it is important to undergo this surgery from the best orthopedic surgeons. Orthopedic surgeons in India are amongst the top orthopedic surgeons around the world. Brachial plexus surgery is available in India at the most reasonable costs.