An injury to the brachial plexus or peripheral nerves is an injury to the nerves that supply the arms and hands. Among these injuries are birth-related palsies, traumas, and tumors.

The brachial plexus is a chain of nerves that runs from the cervical spine in the neck to the arm, shoulder, and hand. It is these nerves that stimulate the muscles of the upper extremity as well as transmit sensation or feel of the arm. The nerves in the upper extremities can be injured in various ways, resulting in multiple degrees of weakness or paralysis.

There are various types of nerve injuries, including pulling, stretching, tearing, and compression. Nerve injury is temporary for some patients, and with occupational therapy and time, they can recover most, if not all, of their function. In severe cases, however, nerve damage may require surgery and occupational therapy.

Signs and symptoms of brachial plexus injuries

A brachial plexus or nerve(s) injury results in weakness or paralysis of the arm. Babies will not be able to move their affected arms. Some babies will regain function in their fingers and hands during the first few months after birth with less severe injuries. However, it can be difficult to tell if they have numbness in the arm. When a baby suffers a brachial plexus injury, they usually hold the affected arm by their side, with the elbow straight and the hand and forearm are facing in.

Additionally, older children may complain of weakness or lack of movement in their shoulders, arms, or hands. Their fingers may feel numb. Both babies and older children may also sustain other injuries, such as broken ribs, collarbones, shoulders, or upper arms. In addition to ptosis (droopy eyelid), there may also be smaller pupils on the affected side.


It is a readily correct condition with surgery involving strengthening the remaining thumb and excision of the extra digit. Soft Tissue Injuries Hand injuries require careful evaluation. Despite seemingly minor injuries, improperly treated nailbed and hand injuries can cause significant distress to the patient.

Hand fractures

The most common type of injury to the hand is a fracture. These can be treated differently, like splinting, k-wiring, screws, mini plates, wires, external fixators, etc. The kind of fixation depends on the location and type of fracture. Tendon injuries Tendon injuries are commonplace when a sharp object injures the hand. Though the external injury may seem innocuous, the damage caused may be severe. These kinds of injuries need careful surgery, prolonged immobilization, and physiotherapy for good results.

Nerve grafting

Nerve injuries are best treated at the time of injury itself; however, nerve grafting is most likely to be needed if the treatment is delayed. Nerve injuries treated by nerve grafting usually have a protracted recovery. The nerve for grafting is usually harvested from the leg.

Tendon grafting

A tendon graft is necessary whenever there is a loss of tendon or a long delay in treating a tendon injury. These involve replacing the tendon gap by surgery and a prolonged course of splintage and physiotherapy. Thumb and finger reconstructions Loss of a thumb or a digit can be quite a devastating injury reconstructions of the thumb and fingers are possible through toe transfers, osteoplastic reconstructions, transfer of the neighboring digits to the thumb, the distraction of the existing one, etc a good reconstruction.

Post Burn Deformities

Hand burns are common. Deep burns of the hand cause scarring and can restrict the function of the hand. Timely surgery can alleviate such problems. Like all other hand surgeries, compression splinting and physiotherapy form an integral part of treating these conditions.

Peripheral Nerve Surgery

The brain and spinal cord make up the central nervous system. Nerve regeneration tends not to occur in these locations, so injuries in these areas tend not to heal quickly. Peripheral nerves, on the other hand, are remarkably capable of regeneration. If repaired on time, even completely severed peripheral nerves can regrow, allowing the patient to enjoy full, or nearly full, recovery in most cases.

Whenever a peripheral nerve is cut, the axons distal to the injury (furthest away from the spinal cord) die off in a process known as "Wallerian degeneration."

When the nerve is repaired, the axons in the proximal segment (closest to the spinal cord) grow into the denervated distal segment. The growth occurs at about one millimeter per day—approximately one inch per month, or one foot per year. Once the axons have grown back into the denervated muscles, the muscles will begin to function again. If the axons do not regrow into the muscles within the appropriate amount of time, the muscles will atrophy and become paralyzed.

When it comes to peripheral nerve injuries, this is a crucial point to note. Healing almost always takes a considerable amount of time. Patients should not lose hope during this period. Exercise is crucial for keeping the affected muscles and joints flexible and ready to be used after the axons regrow into them. Patients often undergo a lengthy, complex peripheral nerve reconstruction procedure, only to see no signs of recovery for a year or more after the process. Patients are often frustrated by this. Currently, medical science has no way to make these axons grow any faster. Consider this delay as part of the healing process, which is paving the way to better health!


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Opp. Akashwani Kendra, near Shree Medical, Jalna Road, Aurangabad, Maharashtra 431001.

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