Our orthopedic surgeons at NYU Langone determine if surgery is necessary to repair the brachial plexus injury. Doctors may recommend reconstructive surgery when nonsurgical treatments are not effective in decreasing pain and improving mobility. If a brachial plexus injury is severe—for example, if movement is extremely painful or restricted, or if the shoulder became dislocated during the injury—surgery may be the first treatment recommended. Doctors at Hassenfeld Children’s Hospital at NYU Langone provide surgical care if your child experiences a brachial plexus injury that requires surgery.
Our reconstructive orthopedic surgeons at NYU Langone are highly experienced and perform nearly 4,000 orthopedic surgeries each year. NYU Langone also has one of the largest hand surgery programs in the United States, providing comprehensive care for injuries to the hand, wrist, finger, and forearm.
Brachial plexus reconstructive surgery uses microsurgery techniques to repair injured muscles and tendons, repair or replace damaged nerves, and restore sensation and movement in the arm, elbow, wrist, and hand. During this procedure, surgeons use tiny, precision instruments and a microscope to reconnect and repair nerves. They also use electrophysiologic monitoring, also known as neuromonitoring, to observe your nervous system throughout surgery and prevent nerve damage.
An avulsion is the most severe type of brachial plexus injury that occurs when one or more of these nerves are torn away from the spinal cord, resulting in a loss of movement in the shoulder or arm. To repair the damaged nerves and help restore movement, our orthopedic surgeons perform a nerve transfer using a nerve from another part of the body, or end-to-end repair, which restores a partially functioning nerve.
Our experts also use an innovative surgical technique called a contralateral C7 transfer. During this procedure, the nerve root from the seventh bone in the cervical spine from the unaffected side of the body is used to repair the injured brachial plexus nerve. For more complex brachial plexus injuries, muscle and tendon transfers may also be used.
Our orthopedic specialists also perform external or internal neurolysis—the surgical removal of a damaged nerve—to eliminate scar tissue that could trap nerves, causing pain, tingling, numbness, or weakness.
You may be able to return home the same day of your procedure, otherwise you may stay overnight. Before you leave, our pain management specialists ensure you receive medication to help you feel comfortable, and a physical therapist assesses your range of motion.
Within a week, you see your doctor for a follow-up appointment to determine if you are ready to begin physical and occupational therapy. Our NYU Langone therapists tailor a postsurgery exercise program. After you complete the program, you see your doctor so that they can assess your progress.
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