BRACHIAL PLEXUS PROCEDURES

Total Paralysis

 

CASE 1

A 22 years old software professional. A motor cycle accident led to avulsion of all five roots.

Treatment

Three nerve transfers were done: Spinal accessory to suprascapular for getting shoulder abduction, intercostal nerves to the musculocutaneous for the biceps to get motion of the elbow and right C7 to the lateral cord for the pectoralis major to get the shrugging motion of the shoulder.

 

CASE 2

Four year girl, fell off a tractor and suffered avulsion of all five roots of the left brachial plexus.

Treatment

Transfer of spinal accessory to the suprascapular for the shoulder abduction and external rotation, intercostal nerves to the musculocutaneous for the biceps to get motion of the elbow, and right C7 to the median nerve for the left hand function.

 

CASE 3

Avulsion of C6C7C8T1 roots and rupture of C5 root in the neck

Treatment

Transfer of Spinal accessory to the suprascapular for the shoulder abduction, intercostals to the musculocutaneous for the biceps to get motion of the elbow and C5 to the lateral cord for the pectoralis major.

CASE

Avulsion of C5, C6 and C7 roots on the right side

Treatment

Transfer of spinal accessory to suprascapular was done to get shoulder abduction and intercostals to the musculocutaneous for the biceps to get motion of the elbow. Ulnar nerve transfer was not feasible because C8T1 function was incomplete.

CASE

Avulsion of C5, C6 and C7 roots on the right side

Treatment

Transfer of spinal accessory to suprascapular for the shoulder abduction, ulnar nerve to biceps to get motion of the elbow, and intercostals to the triceps to get the stretching of the arm.

CASE 1

Avulsion of right C5 and C6 roots

Treatment

Transfer of spinal accessory to suprascapular for the shoulder abduction and external rotation and of ulnar nerve (10%) to the biceps to get motion of the elbow.

 

CASE 2

Left handed peon in a bank. Avulsion of right C5 and C6 roots.

Treatment

Transfer of spinal accessory to suprascapular for the shoulder abduction and external rotation and of ulnar nerve (10%) to the biceps to get motion of the elbow.

Background

Rupture of the right axillary nerve below the clavicle

Treatment

Nerve grafting was done and full shoulder abduction achieved.