Traumatic Brachial Plexus Injuries in Adults

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Brachial plexus injuries (BPI) are the most severe nerve injuries of the upper extremity which results in marked functional impairment. Trauma due to road traffic accidents is the most common aetiology. and middle aged males are most commonly affected. Diagnosis is mainly by clinical examination while electrophysiological studies only confirm the diagnosis and provide information regarding the number of roots involved and the type of injury. Imaging in the form of CT myelography or MRI is mainly useful to look for evidence of root avulsions which necessitate early treatment. Typically, surgical procedures are indicated, if no spontaneous recovery is seen within 3 months of injury. Various options are available which include direct nerve repair, nerve grafting and nerve transfers. Outcome depends on the severity of injury. Good-to excellent outcomes can be expected in partial plexal injuries while global injuries have consistently poor results worldwide.