Brachial plexus injuries – outline and approach

he Brachial plexus constitute afferent motor and efferent sensory nerves supplying the upper extremities. It is situated in a very vulnerable T anatomical position between the neck and shoulder. Injury to this plexus, which is often due to traction, results in various degrees of motor and sensory deficit to the involved upper limb. This results in loss of function and its catastrophic consequences. Two different groups of patients are observed in Brachial plexus injuries, which differ in presentation and also in the approach in management. Obstetric Brachial plexus injuries are a result of traction injury during a difficult delivery of a child. Adult Brachial plexus injuries are usually a consequence of motor vehicles accidents. Etiology of both these types of injuries are however similar, resulting from a forceful traction at the neck shoulder angle. The experience of the authors in the management of 196 brachial plexus injuries is represented.