The success of surgical treatment of brachial plexus injuries largely depends on the extent and nature of nerve damage, the distance of the injury from target organs, the age of the patient, the timing and type of the procedure, rehabilitation and patient compliance. Treatment results are usually better in younger patients and for injuries which are closer to target organs. The ability of the patient to learn and his or her motivation is of crucial importance. In cases of primary reconstruction, the results usually cannot be seen until several months after the operation. In this time, the patient must participate in the rehabilitation process.

The results of secondary procedures, without nerve repair (local muscle and tendon transfers and bone and joint treatment), are predictable and immediate.

The final outcomes of primary brachial plexus reconstruction are generally superior compared to secondary procedures. We strongly recommend that patients or referring doctors consult brachial plexus experts on time.

Every patient (or his parents) should be properly informed about the condition and limitations of surgical treatment, as well as the expected outcomes. A full recovery of function cannot be expected in all patients due to the nature of their injuries. On the other hand, a patient with great functional impairment greatly benefits even from a partial return of function.

1 Late presentation of the right upper plexus lesion with complete absence of active elbow flexion.
2 A year after the reconstruction of elbow flexion with free functional gracilis muscle transfer.

 

3 Ten months after a left upper plexus lesion with severely limited shoulder abduction.

 

5 Ten months after a left upper plexus lesion with absent active elbow flexion.
6 Eleven months after reconstruction of elbow flexion with a transfer of part of the ulnar nerve to the branch (biceps brachii) of the musculocutaneous nerve – Oberlin procedure.

 

7 The result of multiple nerve transfers after obstetric bilateral brachial plexus palsy with the avulsion of upper roots and complete absence of active elbow flexion and shoulder motion. The operation was carried out at the age of 10 months.