Treatment of Burner's Syndrome with Brachial Plexus Nerve Root Avulsion and Pre-Ganglionic Damage
This protocol covers the specific management of Burner's syndrome in the setting of brachial plexus nerve root avulsion with pre-ganglionic damage — the most severe injury pattern, which cannot resolve through natural healing and requires timely surgical intervention.
Clinical scenario
Brachial plexus nerve root avulsion with pre-ganglionic damage represents the worst form of stinger injury (Grade IIIB). It is characterised by nerve root avulsion and pre-ganglionic damage. This pattern is irrecoverable through the body's innate healing process and requires surgical intervention to facilitate functional recovery.
Treatment approach (partial)
Management in this scenario centres on timely surgical reconstruction of the injured nerve, with nerve transfer as a key component of the operative strategy — the complete protocol specifies the full selection of techniques, sequencing, and supporting measures.
Recovery of shoulder abduction
Recovery of elbow flexion
References
DOI: 10.3390/app15073510
- The worst form is a Grade IIIB stinger, characterized by nerve root avulsion and pre-ganglionic damage.
- Grade III stingers are irrecoverable through the body's innate healing process and require surgical intervention to facilitate functional recovery.
- For athletes who sustain Grade III injury with nerve root avulsion or neurotmesis, the mainstay of treatment is timely surgical reconstruction of the severed nerve with the addition of non-operative treatment protocols.
- Surgical repair options include direct anastomosis, interposition grafting, and nerve transfer with an associated partial or complete sacrifice of a less-needed healthy nerve.
- Shoulder abduction and elbow flexion are the two crucial functions that are the focus of surgical repair.
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