Management of Brachial-Plexus Injuries (Traction Type)

¹ Orthopaedic Surgery Service, Lackland Air Force Hospital, San Antonio, Texas

Brachial-plexus injuries from violent traction may result in permanent intraneural damage. This damage may occur within the plexus proper, that is, trunks, divisions, or cords or it may occur by avulsion of the nerve roots forming the plexus. Clinically, these injuries result in a variety of neurological deficits but roughly follow the pattern of obstetrical palsy. They may be further classified on the basis of myelographic findings. The deficit, with the exception of total and permanent plexus loss, is amenable to reconstructive surgery. Reconstructive procedures should aim at shoulder stability, elbow flexibility, thumb opposition, and hand grasp. A definite plan of treatment must be instituted. The utilization of diagnostic myelography and the early performance of surgery, when indicated, is urged to shorten morbidity and return the patient to work as soon as possible.

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