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J Reconstr Microsurg 2005; 21(7): 435-440
DOI: 10.1055/s-2005-918895
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Lacerations to the Brachial Plexus: Surgical Techniques and Outcomes

Daniel H. Kim1 , Judith A. Murovic1 , Robert L. Tiel2 , David G. Kline2
  • 1Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, New Orleans, LA
  • 2Department of Neurosurgery, Louisiana State University Medical Center, New Orleans, LA
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Publication History

Accepted: June 7, 2005

Publication Date:
30 September 2005 (online)

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ABSTRACT

The charts of patients with 201 brachial plexus elements sustaining operative lacerations and managed at Louisiana State University Health Sciences Center (LSUHSC) were reviewed retrospectively. Results for elements injured by sharp transections and undergoing suture repairs performed within 72 hr, as well as secondary suture and secondary graft repairs are documented. Similarly, results for secondary end-to-end suture anastomosis and secondary graft repairs for elements sustaining blunt transections are reviewed. Results for neurolysis, end-to-end suture anastomosis, and graft repairs for plexus elements in continuity despite the laceration injury are reviewed.

Outcomes for the LSUHSC series of brachial plexus lacerations are one of the best of all LSUHSC plexus injuries, even for elements generally viewed as unfavorable for repair. Lesions in continuity with positive nerve action potentials (NAPs) had the best outcomes.

KEYWORDS

Brachial plexus laceration injury - nerve action potential - neurolysis - nerve graft - nerve repair

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Daniel H KimM.D. 

Department of Neurosurgery, Stanford University Medical Center

300 Pasteur Drive, Edwards Building, Room 201

Stanford, CA 94305-7813