Brachial Plexus Injury
Download a PDF brochure about the Brachial Plexus Injury Program at Children's Hospital of Wisconsin. (English, Spanish).
Brachial plexus injury is a birth injury that occurs in about 1 in 1,000 births. It most often affects large babies who get stuck in the birth canal and need to be pulled by the head. This can cause the nerves in the neck to be stretched or broken.
Babies with brachial plexus injury will have:
- Little or no use or feeling in the arm or hand.
- Little use of the wrist and hand, but able to move the arm.
- Good control of the hand, but unable to use the shoulder or elbow.
The brachial plexus is a network of nerves that carry signals from the spinal cord to the arm and hand. With brachial plexus injury one or more nerves may be injured and each nerve may have a different type of injury.
The types of nerve injuries from mild to serious are:
Praxis: A nerve is damaged but not torn. Swelling may temporarily block signals.
Neuroma: A nerve has been injured and has tried to heal itself. Scar tissue has grown and puts pressure on the injured nerve. The nerve is not able to carry signals to the muscles.
Rupture: A nerve is torn, but not where it attaches to the spinal cord. It cannot carry signals to the muscles.
Avulsion: A nerve is torn from the spinal cord and cannot carry signals to the muscles.
Treatment
Children with brachial plexus injury should be seen by a doctor as soon as possible. Early detection is important for successful healing. Physical and occupational therapy will be started immediately to keep the muscles and joints moving.
For many babies, the injury will begin healing within the first three months. If the baby does not show improvement in three months, the baby should see a pediatric neurologist. One out of 10 babies with brachial plexus injury will need surgery to repair the damage.
Surgery
Surgery may help babies who do not improve by 3 months of age. The surgery is performed by a pediatric neurosurgeon. Results are best when the surgery is done between 4 months and 1 year of age.
After one year of age, surgery on the nerves will not be as successful. A tendon transfer may need to be done by a reconstructive surgeon to help improve arm movement and muscle function. |
