How is a brachial plexus injury treated?
How is a brachial plexus injury treated?
Since brachial plexus injuries are typically caused by traumatic, forceful events, many people have additional injuries. These may include:
- Artery or vein injuries.
- Shoulder, arm, spine and/or rib fractures.
- A collapsed lung.
- Spinal cord injury.
- Traumatic brain injury.
Because of this, your healthcare team may need to treat these more life-threatening injuries before they start treating the brachial plexus injury.
A brachial plexus injury is best managed by a team of medical professionals that may include a:
- Neurologist.
- Neurosurgeon.
- Hand surgeon.
- Physical therapist.
- Occupational therapist.
- Primary healthcare provider.
There are two main types of treatment for brachial plexus injuries: nonsurgical and surgical.
Nonsurgical treatment of brachial plexus injuries
Many brachial plexus injuries will heal without surgery over a period of weeks to months, especially if they’re mild. Nerve injuries that heal on their own tend to have better outcomes in terms of muscle and nerve function.
If your healthcare provider thinks that the injury has a good potential for recovery without surgery, they may wait to see how your injury heals before considering surgery.
Your provider may recommend physical therapy as your injury heals to prevent joint and muscle stiffness. You’ll also likely need to rest your arm and shoulder and avoid strenuous activities.
Surgical treatment of brachial plexus injuries
Healthcare providers typically recommend surgical treatment for brachial plexus injuries when the nerves don’t heal on their own or don’t recover enough to restore necessary function to your arm and hand.
It’s important to know that depending on the severity of the injury, surgery may not be able to return your arm or hand to its abilities before the injury.
Neurosurgeons use several different techniques to treat nerve injuries, depending on the type and severity of the injury and the amount of time that has passed since the injury.
Types of surgical procedures include:
- Nerve repair: In this procedure, your surgeon reattaches the two torn edges of a severed nerve. Surgeons typically perform this type of procedure immediately for sharp lacerations to your nerves, such as from a knife wound.
- Nerve graft: In this procedure, your surgeon takes a healthy nerve from another part of your body and sews it in between the two ends of a lacerated (severed) nerve. Your healthy, transplanted nerve functions as a scaffold to support your injured nerve ends as they grow back together.
- Nerve transfer: Surgeons perform this procedure when there are no functioning nerve stumps in your neck to which nerve grafts can be connected. In this procedure, the surgeon cuts and reconnects a healthy donor nerve to the injured nerve to provide a signal to a paralyzed muscle.
Neonatal brachial plexus injury treatment
If your newborn has a mild brachial plexus injury, their provider will likely recommend gently massaging their arm and range-of-motion exercises for treatment.
If the damage is severe or it doesn’t improve within the first few weeks, your baby may need to see a pediatric neurosurgeon. They may consider surgery if your baby’s strength doesn’t improve by three to nine months of age.