Brachial plexus injuries may occur for a variety of reasons, but they most commonly occur due to childbirth complications. The brachial plexus are a large group of nerves located along the neck and shoulder that control the mobility of the coordinating arm. Loosely translated, the term “brachial” means arm and “plexus” indicates a network or group. This network of nerves conducts signals travelling from the spine to the shoulder, arm, and hand for the designated side of the body.
Brachial Plexus Injury Causes
Causes of a brachial plexus injury may include:
- Prolonged maternal labor
- Large birth weight
- Fetal breech presentation, or other birth complications that may require an attempt to adjust the position of the fetus
- Pre-delivery trauma
- Shoulder dystocia during the infant’s delivery
- Amniotic band syndrome
- Congenital chicken pox
- Parsonage-turner syndrome
- Contact sports, such as football
- Severe motor vehicle accidents
- Attempts to adjust shoulder dislocation without proper medical training
Brachial Plexus Injury Symptoms
The following are warning signs that may be symptoms of a brachial plexus injury:
- Weakness in shoulder, arm, wrist, or hand
- Lack of mobility or control in shoulder, arm, wrist, or hand
- Deteriorating reflex abilities in shoulder, arm, wrist, or hand
- Sensory deficits, such as lack of touch, feeling, or ability to grasp objects
- Limp or paralyzed shoulder, arm, wrist, or hand
Types of Brachial Plexus Injuries
Brachial plexus injuries can occur in a variety of stages and levels. Some types of brachial plexus injuries result in severe and permanent damage to the nerves, which can mean permanent loss of arm mobility for the patient. In all cases of brachial plexus injury, it is critical to receive any necessary surgery and begin physical therapy for the affected arm as soon as possible. Prompt treatment will help salvage arm mobility for the patient.
Neuropraxia
Neuropraxia is also known as praxis injury. This is the mildest type of brachial plexus injury. The patient’s nerves are not actually torn, so they do not require surgery. In conjunction with physical therapy, the nerves will typically heal in a couple of months, and the patient will regain total control of his or her arm.
Neuroma
A brachial plexus neuroma is considered a moderate type of brachial plexus injury. Scar tissue may form around the patient’s damaged nerves. This adds pressure on the injured brachial plexus nerves as they try to heal. Neuroma injuries may require surgery in cases with excessive amounts of scar tissue.
Rupture
A rupture is a very severe form of brachial plexus injury. During a brachial plexus rupture, nerves are torn, but none of the nerves within the spine are fully torn. As a result, the connection between the spinal cord and the brachial plexus remains intact and can be repairable. Brachial plexus ruptures require immediate surgery and physical therapy for the patient to fully recover. However, recovery may only be partial.
Avulsion
Brachial plexus avulsion is the most severe brachial plexus injury. During avulsion, the brachial plexus nerves tear away from the spinal cord entirely. The connection is completely severed, causing severe pain for the patient. It is extremely difficult to regain mobility after a brachial plexus avulsion, despite surgery and physical therapy efforts.
Permanent Arm Damage
Permanent arm damage resulting from a brachial plexus injury may include:
- Muscular atrophy
- Arthritis
- Horner’s syndrome
- Erb’s palsy
- Klumpke’s palsy
- Complete brachial plexus paralysis
- Carpal tunnel or arthritis may occur in patient’s healthy arm, due to doubled amount of use
Brachial Plexus Injury Recovery
A patient’s treatment will depend on the exact type of brachial plexus injury. For example, neuropraxia injuries do not typically require extensive medical attention. After a brachial plexus injury at childbirth, a 3-month old infant’s ability to bend his or her arm at the elbow is medically considered to be a good indication of full recovery in the future. Newborn babies with neuroma injuries are also likely to recover. However, they may require closer medical attention and a longer period of time to fully heal.
Orlando Brachial Plexus Lawyer
It is extremely difficult to recover fully from a brachial plexus rupture or a brachial plexus avulsion. Both ruptures and avulsions will require immediate surgery and prompt physical therapy. Surgical options for severe brachial plexus injuries can involve nerve grafting, neurolysis, and neurotization. Physical therapy will involve grasping, reaching, raising, and lowering the affected arm. In addition, physical therapy appointments will need to be attended for several years. If your loved needs a brachial plexus lawyer, please contact Paul & Perkins here in Orlando, Florida.
Sources:
“Brachial Plexus.” American Society for Surgery of the Hand. ASSH, n.d. Web. 24 Sep 2013. <http://www.assh.org/Public/HandConditions/Pages/BrachialPlexus.asp&xgt;.
Erb’s Palsy (Brachial Plexus Birth Palsy).” American Academy of Orthopaedic Surgeons. 2010. <http://orthoinfo.aaos.org/topic.cfm?topic=a00077>.