Nerve Grafting Surgery for Brachial Plexus Injuries
When a nerve has been injured or scarred severely, it may no longer be able to carry signals from the brain to the arm and hand, leading to paralysis. In this case, surgeons can remove the damaged nerve segment and replace it with a segment of an expendable sensory nerve from another part of the body, such as the sural nerve in the leg. This procedure helps create a bridge that replaces the injured portion of the nerve and provides a pathway for nerve regeneration.
Brachial Plexus Nerve Transfer Surgery
During a nerve transfer, a nearby functioning nerve that is performing a non-critical function is connected to the injured nerve. This creates a framework for new growth and a pathway for signals. In many cases, a nerve transfer procedure provides the best chance of restoring movement and sensation to the muscles and skin.
Tendon Transfer Surgery for Brachial Plexus Injuries
During a tendon transfer, a functioning and expendable tendon are attached to a tendon that is paralyzed due to brachial plexus injury. After tendon transfer, the functioning tendon will pull on the once paralyzed tendon to restore lost movement in an upper extremity.
Functional Muscle Transplant for Brachial Plexus Injuries
Functional muscle transplant is another option to restore movement when too much time has passed after the brachial plexus injury and when nerve repair, grafting, or transfer is no longer possible. A non-essential muscle, such as the gracilis muscle of the inner thigh, is transplanted to replace a no-nfunctioning muscle in the shoulder, upper arm, or hand.
Recovery After Brachial Plexus Surgery
Recovery after brachial plexus surgery includes healing of the tissues that were operated on and recovery of lost function. While healing of the tissues is relatively quick, function recovery may take months depending on the procedure you had and the extent of the injury.
- After surgery, one may need to use a sling or splint to keep the affected arm.
- For some nerve transfers below the elbow, a splint may be needed for two weeks.
- Nerve repairs, transfers, and grafts above the elbow typically require a sling for only two weeks.
- For tendon transfers and functional muscle transplantation, a sling and/or splint is likely required for one to three months. During this time, you may start physical therapy.
- Physical therapy is critical to help one recover after brachial plexus surgery. The type of therapy, timing, and duration depend on the type of surgery.
After nerve repair, grafting, and transfer, a period of nerve regeneration is required before movement and sensation improved. This can take months to years, depending on the type of surgery performed.