Principles of treatment of brachial plexus injury

Brachial plexus nerve injury treatment principles 1, early and correct diagnosis to grasp the “golden time” after nerve injury, its regenerative capacity and repair time is very close, 1 to 3 months after the injury is the nerve repair “golden period”, delayed diagnosis, the prognosis is poor.

2.Define the nature of nerve injury and decide the treatment plan Nerve oscillation: usually can be healed by conservative treatment; Nerve axonal rupture: there is a possibility of self-recovery, but in between the axonal rupture appears hematoma compression or fibrous tissue extension is difficult to self-recovery; Nerve rupture: must be operated to explore.

3, the correct grasp of the indications for surgery emergency and early surgical exploration: (1) open injury, it is estimated that the nerve has been broken, is unlikely to recover on its own, should be performed as soon as possible nerve exploration; (2) closed nerve injury after a certain period of observation (generally 3 months), no regeneration performance, should be performed surgical exploration; (3) after conservative treatment, although the recovery of partial function, but stay again at a certain level, after 3 months interval (3) after conservative treatment, although partial recovery of function, but stays at a certain level again, after 3 months interval and no recovery of the main function, surgical exploration should be performed; (4) after nerve surgery according to the nerve growth rate of 1mm/d, the function is not recovered should be re-probed nerve anastomosis; (5) after nerve surgery, nerve regeneration again bone fiber tract has obstructed performance.

Late surgical indications: 1 to 2 years after injury patients then the following cases for surgery: (1) the loss of nerve major function has not been restored, or recovery is not satisfactory, muscle atrophy is obvious should be functional reconstruction surgery; (2) nerve injury although several years, the main function of the limb has not been restored, but no significant muscle atrophy, but still Section consider nerve surgery exploration; (3) nerve injury or repair, functional recovery is not one and have The following cases, even if the time is more than 2 years, can also be surgical investigation: the function has been restored, but the progress suddenly stopped; accompanied by nerve injury-related pain.