Operative Brachial Plexus Surgery. Clinical Evaluation and Management Strategies

Adult Brachial Plexus Injuries: A Historical Perspective
Part 1 SURGICAL ANATOMYSurgical Anatomy of the Brachial Plexus
Mechanisms of Injury Biology of Nerve InjuryEpidemiology of Adult Traumatic Brachial Plexus Injuries Associated Concomitant InjuriesEVALUATIONExamination of the Adult Brachial Plexus PatientNeurodiagnostic Evalution: EMG and NCSNeurodiagnostic Evalution: Intraoperative MonitoringAdult Brachial Plexus Injuries: Evaluation-Radiologic EvaluationADULT BRACHIAL PLEXUS INJURIES: DETERMINANTS OF TREATMENT (TIMING, INJURY TYPE, INJURY PATTERN)Priorities of Treatment and Rationale in Adult BPITREATMENT OPTIONS IN ADULTSRoot Grafting in Adult Brachial Plexus InjuriesNerve Transfers to Shoulder and ElbowFree-Functioning Muscle TransferTendon Transfers of the Shoulder, Elbow, Wrist and HandGlenohumeral arthrodesis in brachial plexus palsyReconstructive Options for the Thumb Axis in a Brachial Plexus InjuryWrist arthrodesis in the adult brachial plexus patientSURGICAL APPROACHESSupraclavicular Exposure of the Brachial PlexusInfraclavicular Exposure of the Brachial PlexusPosterior Approach for Spinal Accessory to Suprascapular NerveSurgical Approach: Axillary PosteriorAnterior Approach for Axillary Nerve ReconstructionUpper brachium approach: the "Ulnar-Biceps Median-Brachialis" double nerve transferIntercostal nerve harvest in brachial plexus injuriesSural Nerve HarvestContralateral C7 nerve transfer in the Treatment of Adult Brachial plexus Injuries and Spastic HemiplegiaThe harvest of a free innervated functional gracilis muscle and its use in brachial plexus injuriesMANAGEMENT OF SPECIFIC INJURY PATTERNSManagement of C5-6 InjuriesManagement of C5-7 InjuriesStrategies for Pan Brachial Plexus Reconstruction: The Mayo Clinic Brachial Plexus Team ApproachLower type injuries of the brachial plexus (C6-T1, C7-T1 and C8-T1 root involvement)RESTORATION OF HAND FUNCTION IN PAN PLEXUS INJURYRestoration of Hand Function in Pan Plexus Injury - Double Free Functioning Muscle TransferRestoration of hand function in total brachial plexus avulsion injury Intercostal nerve transfer for sensory reconstruction of the hand following complete avulsion of the brachial plexusManagement of Neuropathic PainRole of Amputation and Prosthetic FittingThe Role of Therapy: Pre and Post-Surgery ProtocolsPEDIATRIC BRACHIAL PLEXUS INJURYHistorical PerspectivesMechanism of InjuryThe Biology of Brachial Plexus Birth InjuriesEpidemiology of Obstetrical Brachial Plexus InjuriesAssociated Concomitant InjuriesClinical Examination of the Child with Brachial Plexus Birth InjuryOperative Brachial Plexus Surgery: Brachial Plexus Birth Injury - Neurodiagnostic EvaluationPediatric Brachial Plexus Injuries: Evaluation-Radiologic EvaluationPriorities of Treatment and Rationale (Babies Are Not Small Adults)Treatment Options in BabiesSurgical ApproachesManagement of Specific Patterns of Injury-Erbs and Extended Erbs PalsyManagement of Specific Patterns of Injury-Pan Plexus Expected OutcomesLate Complications and Treatment

Fully illustrated and enhanced with accompanying video clips, this comprehensive text presents the clinical evaluation and management of brachial plexus injuries and reconstruction, both for adult patients and birth injuries. Divided into two main sections, part one covers adult brachial plexus injuries, discussing the relevant anatomy and biology, epidemiology, and associated injuries. The main focus, however, is on diagnosis - the clinical exam as well as neurodiagnostic and radiographic evaluation - and surgical management approaches and techniques, including nerve grafting and transfers, tendon and muscle transfers, and joint fusion. Related topics are presented in chapters on sensory reinnervation, neuropathic pain management, the role of amputation and prosthetics, and pre- and post-surgical therapy protocols. Brachial plexus birth injury is described in part two, also focusing mainly on diagnosis and management but with an emphasis on the fact that babies are not small adults and special considerations are warranted. This section concludes with chapters on the management of late complications and long-term sequelae.

A comprehensive surgical text on brachial plexus injuries has not been previously attempted. Filling a large gap in the literature, Operative Brachial Plexus Surgery is the go-to resource for adult and birth related brachial plexus reconstruction for orthopedic surgeons, neurosurgeons, plastics surgeons, and their trainees.

Author Information

Alexander Y. Shin, MD, Professor of Orthopedic Surgery and Neurosurgery, Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, MN, USA

Nicholas Pulos, MD, Assistant Professor of Department of Orthopedic Surgery, Division of Hand and Microvascular Surgery, Mayo Clinic, Rochester, MN, USA