1.Common causes and manifestations are mostly caused by motorcycle falls, injuries from falls, and injuries from heavy objects. There is also a part of the conveyor belt stirring injury. In the former case, the shoulder joint cannot be lifted, the elbow joint cannot be bent, the hand can be partially functional, and in severe cases, the entire upper limb loses its function. In the latter case, the shoulder can be lifted, but the elbow and hand function is significantly limited. There is also a corresponding sensory deficit. Pain. 2.Treatment strategy There are some injuries that are relatively mild and can gradually restore most of the functions by themselves. However, at present, look at the gradual increase of high-energy trauma and more serious nerve damage, most of them need surgical treatment. The most important thing is to determine the degree and scope of nerve damage in a timely and accurate manner. This requires a careful examination by a professional doctor, combined with electromyography, myelography CT, MRI and other examinations to determine. These examinations are more appropriate to be done about one month after the injury. If the nerve is an avulsion injury and there is no possibility of recovery on its own, surgery is needed as early as possible. The earlier the surgery, the better the result. Surgery within 3 months after the injury is significantly better than surgery at a later stage. 3.Surgical method For nerve avulsion injury, the nerve transposition method is used for treatment. The commonly used donor nerves are the paramedian nerve, septal nerve, intercostal nerve and contralateral cervical 7 nerve root. Previous surgeries required a 3-4 stage division with average results. The surgical plan to be adopted needs to be examined and depends on each person’s condition, which varies. 4.What final result can be achieved? Nowadays, for total brachial plexus avulsion injury, the final surgical results are mostly 30-60 degrees of shoulder lift and 90 to 140 degrees of elbow flexion. Generally, the left and right flexor strength reaches 3-4 levels. Incomplete injuries are even better. These are broad estimates, not exact numbers. Although there has been a lot of progress in terms of the range of motion, there is still a long way to go before the normal use of the affected limb is required. Since there are many nerves in the upper extremity, surgery can only repair the more important ones, and there are many more nerves that cannot be repaired. Therefore, the upper limb will never be very usable. Or, although the affected limb can move some and help some after the surgery, it can never use it as normal. At present, no one in the world has been able to solve this problem. 5.In that case, do you still need treatment? I think every injured patient will have the feeling that the affected limb is no longer their own, they can’t move and have no sensation. It feels very cumbersome, and it is very tiring to carry a useless arm. After the surgery, the affected limb usually regains some simple functions and this feeling of tiredness will disappear. Our patients are ultimately very satisfied, and they all think it is worthwhile to do the surgery. 6.Can I still have surgery if I miss the best time? Surgery is usually recommended within 3 months (if needed). However, sometimes the patient is late to the clinic or the surgery is not scheduled, so it will be delayed a bit. We think it is still possible to do the surgery for nerve displacement within six months. Any later is questionable. Sometimes, the patient is not seen in time, or has been treated before with unsatisfactory results, and now it has been 1 year or even several years, is there anything else that can be done? There is. Depending on the condition, there are some options to reconstruct some important functions such as muscle transposition and free muscle graft. 7.What is the treatment for nerve pain? In general there is no particularly perfect way. Sometimes, it gets better with time, sometimes it gets worse. The first thing is pain medication. Sometimes combined with antidepressants. Secondly, there are other complementary treatments, such as transcutaneous electrical stimulation. But the efficacy is not certain. Finally, when there is no other way, there are nerve closures, spinal cord posterior horn disruptions, and nerve root filament cuts or reconstruction. No one treatment is effective for everyone. 8, the cost of the problem depends on what kind of surgery to do. In general, total brachial plexus injury is more expensive. The first surgery, which is the most important one, costs $50,000. Whether or not to operate later, and what surgery to do, depends on the results of the follow-up. Usually it costs $10,000 to $20,000 a time.