Brachial plexus is a bunch of five nerves originating from cervical spine in neck travelling down in upper limb. The function of nerves is to provide sensation and promote action (motor power). Injury to these nerves can lead to temporary or permanent loss of function in upper limb partially or completely. These injuries can be missed in case of polytrauma due to vehicular accident as there could be injury to many parts of the body. Even if they are diagnosed, many times treatment like physiotherapy or medical treatment is advised for some period by many doctors.
At Pinnacle Orthocentre Hospital, We provide best Brachial Plexus Surgeon & Doctors for Brachial plexus injuries Surgery in Mumbai. Our well-trained and highly qualified Brachial Plexus Surgeon provides the best brachial plexus injury treatment in India.
How can brachial plexus be injured?
There are mainly four reasons in which we see such injuries.
- In cases of difficult pregnancy, while attempting to deliver the baby, traction force may need to be applied. If the head of baby is large or passage is narrow then brachial plexus in neck can be stretched and at birth baby does not show any movement of upper limb
- In adults, brachial plexus gets injured at the time of vehicular accident mainly motor bike. There is usually collar bone (clavicle) fracture or arm bone (humerus) fracture.
- Occasionally we have seen open injury in neck due to piercement of sharp object causing nerve injury.
- Sometimes, tumor or mass in neck region can compress the brachial plexus and lead to weakness in upper limb.
What are the types of nerve injuries?
We usually see three types of injuries.
- Neuropraxia- It means nerve is just stretched out at the time of trauma. Such type of nerve injury recovers completely in few weeks without any surgery
- Axonotmesis- It means the nerve is partially cut. So recovery is also seen partially and many times such injury needs surgery.
- Neurotmesis- It means there is complete transaction of nerve or nerve is completely cut. Such injuries certainly do not recover by any medical management and need surgery at the earliest for better function of the limb
How can we confirm our diagnosis?
Mainly, expert in treating brachial plexus injury can get fair idea about the seriousness of the problem after examining patient in detail. To confirm our diagnosis, we may have to do nerve conduction study & electromyography to know at what level the nerve is injured. MRI of brachial plexus also may need to consider in selected cases.
What are the treatment options?
Fortunately, such injuries though in the beginning gives complete weakness in upper limb, most of the time, they recover in natural way in due course of time. But if weakness that has not recovered in 6 weeks after injury certainly needs proper examination by experts.
Supervised physiotherapy with stimulation of weak muscles, medical drug therapy, mirror therapy, temporary splint can be considered in initial period in such cases.
After examination & investigations, if the diagnosis is made about rupture or avulsion of nerves then surgery is recommended. Surgery done in right time has more benefits and helps patient to gain some function back. Those who have brachial plexus injury more than one year old then muscle/ tendon transfers or bony procedures have role in achieving the lost function.
When do we expect recovery after surgery?
If done in time, in partially injured brachial plexus, the recovery is expected to start in 3 months and may take one & half year after surgery. In patients who have global brachial plexus injury meaning no function in limb at all, they may need two or three surgery in span of two years to achieve some function.
Recovery after surgery depends up on age of patient, duration since injury, medical illnesses, addictions & many other factors.
Does patient need physiotherapy after surgery?
Self-therapy under supervision of trained physiotherapist can certainly add value for speedy recovery.
Please consult Dr Parag B Lad who is expert Brachial Plexus Surgeon in Thane at Pinnacle Orthocentre by prior appointment.