Post-Traumatic Lesions of the Brachial Plexus

TREATMENT BY TRANSCLAVICULAR EXPLORATION AND NEUROLYSIS OR AUTOGRAFT RECONSTRUCTION

¹ From the Departments of Orthopaedic Surgery and Neurosurgery, New York University Medical Center, New York

Between 1963 and 1970 twenty patients underwent exploration of the brachial plexus for post-traumatic neural deficits. Nineteen had paralysis and of these nineteen three had clinically significant pain as well. The remaining patient, previously treated by amputation, had exploratory surgery because of pain. Operation resulted in significant improvement in thirteen of the seventeen who had neurolysis and in both of the patients who had autografting. Pain referred to the peripheral distribution of the plexus was not relieved by silicone capping of the ends of the severed nerves emanating from the plexus in one patient or by neurolysis in two others. Subsequent rhizotomy was helpful in two of these three patients.

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