Reoperative Brachial Plexus Surgery
This chapter provides a very nice outline and summary of options in treating the patient who has experienced no recovery or only partial recovery after a brachial plexus injury. These options are broken down into those that help hand function, elbow function, and shoulder function. Common reoperative procedures to improve the function of a patient with a brachial plexus injury that has not healed from the initial procedures include tendon transfers, joint fusions, and, in some circumstances, sensory nerve transfers in order to maximize the patient’s ability to gain some function with the extremity. In extreme cases, where a patient is having severe chronic pain, as well as in some other unique situations, the option of amputation can be entertained. Expertise in brachial plexus surgery is difficult for the individual hand surgeon to gain unless he or she is at a major referral center. However, fusions and tendon transfers may be within the typical hand and upper extremity surgeon’s repertoire. This chapter outlines these reconstructive options for this difficult and challenging clinical situation.
KeywordsBrachial Plexus Fusion Tendon Transfers
- 1.Bunnell S. Restoring flexion to the paralytic elbow. J Bone Joint Surg Am. 1951;33-A(3):566–71, passim.Google Scholar
- 9.Mayer L, Green W. Experiences with the Steindler flexorplasty at the elbow. J Bone Joint Surg Am. 1954;36-A(4):75–89; passim.Google Scholar
- 12.Ray WZ, Kasukurthi R, Yee A, Mackinnon SE. Functional recovery following an end to side neurorrhaphy of the accessory nerve to the suprascapular nerve: case report. Hand (N Y) 2009.Google Scholar
- 14.Saha AK. Surgery of the paralysed and flail shoulder. Acta Orthop Scand. 1967;Suppl 97:5–90.Google Scholar