Overview of Brachial Plexus Clinic
Children's Hospital offers treatment and surgery for brachial plexus injury. This injury occurs when the brachial plexus nerves in the neck are torn during birth.
How is the brachial plexus injury treated?
It is very important that an infant with brachial plexus injury be seen as soon as possible by a medical specialist from the Brachial Plexus Clinic. The multidisciplinary clinic team includes a pediatric neurologist, a pediatric neurosurgeon, a plastic and reconstructive hand surgeon and occupational therapists.
The pediatric neurologist performs a thorough evaluation to determine the extent of injury and monitor recovery during follow-up visits. Therapy usually is needed to increase range of motion and improve strength and function. Many infants will begin to show signs of healing within the first three months. If healing is not seen, surgery is considered.
The goal of the Brachial Plexus Clinic is to restore maximum function to the injured limb and to promote the recovery process. This is accomplished by making an accurate diagnosis, creating a treatment plan and by educating family members.
Summary of treatment:
- Early comprehensive evaluation.
- Special exercises through physical and occupational therapies.
- Possible surgery.
Surgery for brachial plexus injuries:
Surgery may help children who do not recover good muscle function by 3 to 6 months of age. In these cases, surgical repair of the damaged nerves in the brachial plexus may be recommended. This includes either removing scar tissue from around the nerves (neurolysis), repairing torn nerves (nerve grafts), and/or nerve bypass (neurotization). Having this procedure performed between 4 and 12 months of age offers the best opportunity for improving muscle strength and arm/hand function.
Performing this special surgery is the task of the pediatric neurosurgeon and the plastic/reconstructive hand surgeon. These highly trained surgical specialists perform this surgery under high magnification, using a special microscope and microsurgical techniques. The extent of the injury also is seen by performing an EMG in the operating room. In children older than 2 years, nerve surgery may no longer be an option. Muscle and tendon transfers might be recommended for these cases to improve shoulder, arm and hand function.
Exercises for brachial plexus injury
Early therapy is encouraged for children with brachial plexus injury for best results. Occupational therapists work with the physicians in the Brachial Plexus Clinic to provide evaluation and treatment.
Specific range-of-motion exercises prevent the muscles and joints from becoming very tight. This is important so that when the recovered nerves send signals for movement, the muscles and joints will be able to respond. Other activities provided by the therapists help to promote muscle strength and endurance, encourage functional use of the arm, improve coordination, help to normalize the child's sense of touch, and increase the child's awareness of the arm. In addition, splinting may be utilized to stretch tight muscles and joints, or to position joints for improved function. Parents receive important education to provide daily home exercises. The Brachial Plexus Clinic team also provides guidance to outside therapists if needed.
Family-centered care
At Children's Hospital of Wisconsin we provide family-centered care because we know that a child's health affects the whole family. We create a partnership with families talking openly and often about their child's care and their personal beliefs. Our goal is to support families by building on their strengths.
Comfort Zone
Many parents worry about their child being in pain when visiting the hospital. Talk to your child's health care team about your fears. The Comfort Zone is our pledge that we will make every effort to keep your child comfortable during his or her visit to Children's Hospital.
Location
The Brachial Plexus Clinic meets in Neuroscience Center on the second floor of the Children's Hospital clinics building.
Hours
1 p.m. to 4 p.m. on the 1st, 3rd and 5th Thursday afternoon of every month.
To request an appointment, click here.
Who will I see?
You will see a nurse, pediatric neurologist, an occupational therapist and possibly a surgeon. Occupational therapists work closely with the health care team and play a vital role in the recovery process.
Multidisciplinary care
It takes many people to care for a child. We provide multidisciplinary care, which means we have a team of specialists available to care for all of your child's needs. They include doctors, nurses, therapists, child life specialists, respiratory care practitioners, pharmacists, dietitians, psychologists, social workers, laboratory and radiology technologists, volunteers, pastors and even clowns.
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