Brachial plexus and peripheral nerve injuries

Nerves are unique in their structure – a single cell runs from your neck to the tips of your fingers – and in their ability to regenerate. Once injured, they do so from proximal to distal, and only at 1mm per day. If you have a proximal nerve injury and the nerve has to regrow 30cm or 300mm – 300 days is a long time! Motor nerves supply the muscle and exert their action through the motor end plate. This motor end plate however degenerates if it does not receive signals from the injured nerve, so time is of the essence!

The brachial plexus is a complex of nerves that supply the arm and shoulder. Injury to it is usually devastating for the patient, as many may not be able to lift their shoulder or some unable to lift their arm or use their hand at all. There are however numerous options in terms of surgical management that can be performed in order to maximise shoulder and arm function. Due to both the complexity of the anatomy and the difficulty of surgery, it is imperative that you seek out a surgeon who is highly experienced in this field.

Peripheral nerve injuries, although more well defined, also require high level surgical expertise. Usually it occurs following sharp trauma lacerating a specific nerve or occasionally a significant blunt injury might cause a defect in the nerve and it require a graft. Both types of injuries require meticulous suturing, under loupe magnification and using sutures often thinner than human hair, in order to correctly align the nerve to regenerate as best possible. These injuries are best managed by a specialized hand surgeon.

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