Treatment of Brachial Plexopathy in Closed Brachial Plexus Injury Without Other Emergent Injuries

Closed brachial plexus injury (BPI) without concurrent emergent injuries defines a specific clinical scenario in which the urgency and sequencing of surgical management differ substantially from open or multi-trauma presentations.

Clinical Scenario In closed BPI when no other emergent injuries are present, immediate surgical exploration and reconstruction may not be undertaken. The absence of competing urgent injuries permits a staged, deliberate approach — with the timing of intervention guided by the pattern of recovery.

Treatment Overview (Partial) When spontaneous recovery does not occur, or when an initial surgical procedure fails to produce satisfactory outcomes, secondary reconstructive surgery becomes the focus. The complete structured regimen — specifying the reconstructive options, their indications, and the decision pathway — is available in the full protocol. Full regimen details, sequencing, and criteria available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

In the case of closed BPI wounds and when there are no other emergent injuries, surgical exploration and recovery may not take place immediately.

In the absence of spontaneous recovery or when the first surgical procedure does not provide satisfactory outcomes then a second operation may be required.

Arthrodesis, tendon transfer, and functional free muscle transplantation are our favored treatment options.

DOI: 10.1155/2014/314137

View source ↗