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NABH

Neuro Reconstructive Surgery Department

Brachial Plexus Injuries

Brachial plexus is a network of nerves that control movement and sensation of upper limb.Injury to these nerves produce varying degrees of upper limb dysfunction .

As each patient is different in terms of extent of injury,the treatment protocol varies for each patient.some brachial plexus injuries may heal spontaneously without any treatment.

Spontaneous recovery - waiting period is only 2-3 months. If no recovery after that period surgical intervention is the choice .The purpose of surgical intervention is to promote recovery of the nerves ,or to improve the function of the affected limb.

Surgical options include primary nerve repair,nerve grafting,nerve transfers,neurolysis,muscle transfers,tendon transfers,,and combination of these procedures.unfortunately complete recovery is not possible in certain types of injury like global plexus palsy(all nerves damaged).Prognosis depends upon the the site and type of nerve injury,timely surgical intervention and good post surgery physiotherapy by an efficient team.

Obstetric Brachial Plexus Palsy{OBPP} : Brachial plexus injury during child birth is called OBPP.Many children who are injured during birth improve or recover completely by 3-4 months of age.if there is no significant improvement after 4 months,surgical intervention is the choice.There is no point in waiting beyond that age with physiotherapy.

Facial Palcy

Patients with facial palsy experience varying degrees of paralysis of one half of the face-mainly difficulty in closing the eye completely and deviation of angle of mouth.

In some patients symptoms are mild and can be treated with a course of steroid,electrical stimulation and physiotherapy.In cases where symptoms are severe or permanent surgery is done to restore the function and appearance of the face.

Surgical options include direct nerve repair,nerve grafting,crossover nerve transfers and facial reanimation procedures like masseter muscle transfer,temporalis muscle transfer,micro neuro vascular procedures like gracilis muscle transfer.

Facial reanimation procedures for facial palsy is very successful although it can take upto two years to see the full result.patients with facial palsy should be seen by a multidisciplinary team consisting of a plastic surgeon,neurosurgeon,opthalmic surgeon and a physiotherapist to achieve a good result.

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Meet Our Doctors

Dr.S.Sureshkumar
Dr.S.Sureshkumar

MS;M.Ch (Plastic Surgery)

Senior Consultant Plastic & Reconstructive Surgeon