Intraoperative Assessment of Nerve Traction Injury in Obstetric Brachial Plexus Palsy

• Published in: Journal of brachial plexus and peripheral nerve injury Vol. 20; no. 1; pp. e27 - e30
• Main Authors: Bahm, J., Schäfer, B., Nolte, K., Weis, J., Beier, J.P.
• Format: Journal Article
• Language: English
• Published: United States Thieme Medical Publishers Inc 01.01.2025; Georg Thieme Verlag KG
• Subjects: Acupuncture; brachial plexus; Cerebral palsy; endoneurium; fibrosis; Injuries; Maxillofacial surgery; minifascicles; nerve regeneration; nerve traction; Nervous system; obstetric palsy; Obstetrics; perineurium; Shoulder; nerve traction; brachial plexus; perineurium; fibrosis; nerve regeneration; endoneurium; minifascicles; obstetric palsy
• ISSN: 1749-7221; 1749-7221
• DOI: 10.1055/a-2572-2601

We present an easy classification for nerve lesions observed in reconstructive surgery for obstetric brachial plexus palsy, performed through a supraclavicular approach and systematic exposure of nerve roots and trunks. A description of signs related to nerve traction injury (scarring, fascicular rupture, and dislocated ganglions) is combined with a grading system of microscopic tissue changes occurring in slices from traumatized nerve endings (fascicular structure, changes in perineurium and endoneurium). Both tools are proposed for any surgical brachial plexus exploration and later interaction with other professionals (pediatricians, physiotherapists, or obstetricians).