Root avulsion injury of the whole brachial plexus is a very serious peripheral nerve injury, which is a disaster for patients and their families. Currently, the conventional treatment at Huashan Hospital is multi-group nerve transposition repair, i.e., paramedian nerve repair of the suprascapular nerve; repair of the musculocutaneous and median nerves by the healthy cervical seven nerve roots; and intercostal nerve repair of the radial nerve. Today’s focus is on the considerations for your patients after intercostal nerve transposition. For patients with total brachial plexus injury, the intercostal nerve is also an important donor nerve donor area. At Huashan Hospital, we routinely use intercostal nerve transposition to repair the radial nerve trunk or triceps muscle branch, and also the median nerve. The intercostal nerve can also be used to repair the musculocutaneous nerve or axillary nerve in patients with upper middle trunk injuries. Different repair methods are used depending on the patient’s injury. The intercostal nerve can usually be cut from 2 to 4 nerves, so it usually does not affect the patient’s breathing, but for older patients or infants, we will carefully consider whether to do the intercostal nerve, and this patient can be completely at ease. However, for some patients with a full brachial plexus who must have more than four intercostal nerves removed, what discomfort may occur in these patients? First of all, breathing difficulty or difficulty in breathing when moving: these patients often have a pleural effusion or rib fracture and other comorbidities, when a day or two after the operation, patients do not need to be nervous about breathing discomfort, the more nervous they are, the more difficult it will be to breathe, then you can report your feelings to the doctor in charge or oxygen therapy, usually three or four days after the improvement will be improved. The second is the chest pain and discomfort: this is related to the cutting of the sensory branch of the intercostal nerve, but also related to the patient’s own physique, the incidence of female patients is significantly higher than male patients, early symptomatic treatment can be, these adverse reactions will improve, but the late nerve function restored patients in touching the back of the hand often appear chest pain and discomfort, in fact, is a good phenomenon that the nerve has regenerated, patients do not need to be nervous, with the further recovery of the function of this feeling will With the further recovery of the function of this feeling will slowly reduce. The third is bleeding blood: this is a more serious complication in the early postoperative period, we must take it seriously, in addition to intraoperative thorough hemostasis and drug application, the patient himself needs to pay attention to things if still in the hospital, negative pressure drainage ball daily drainage more than 20 ml that should be reported to the medical staff, of course, we will also observe to make the treatment, the key is discharged home found underarm swelling or incision constantly In order to prevent this kind of bleeding after discharge, I will ask the patient not to remove the drainage ball after discharge, but let the patient take it home to the next day to observe if there is no fresh blood in the drainage ball or similar to the discharge, then you can go to the local hospital to remove the negative pressure drainage ball, this is by no means lazy or forgotten by our doctors at Huashan Hospital, but because This is not because our doctors at Huashan Hospital are lazy or forgetful, but because of the bleeding reaction caused by the bumps in the car and train on the way home, if the drainage ball is removed then the bleeding will accumulate in the incision and cause the hematoma to compress the repaired nerve. This is a very important precaution that I hope all patients undergoing intercostal nerve transplantation will take note of. Finally, exercise: after intercostal nerve transposition, you should also start exercising after one month. The main action is to think about doing elbow and wrist extension (to repair the radial nerve) when breathing hard, or think about flexing the elbow (to repair the musculocutaneous nerve) and flexing the wrist and fingers (to repair the median nerve), or think about shoulder abduction (to repair the axillary nerve). Do this at least 1500 times a day in three sessions. The last thing I would like to tell you is that intercostal nerve transposition is often the last surgery done for all nerve repairs, which means that the first phase of nerve repair is complete. Patients feel more tired after multiple surgeries, especially older patients, so it is important not to be in too much of a hurry to start exercising after surgery, but it is very important to insist on exercising, and to be persistent, and also to Regular review according to medical advice: I recommend a review every three months. This will allow the doctor to know whether you are recovering or not, especially if the exercises are correct, and to guide the patient, which is equally important for nerve recovery. I sincerely hope that patients with brachial plexus injuries can return to normal work and life as soon as possible.