Late Reconstruction for Brachial Plexus Injury

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38 Scopus citations


Traumatic brachial plexus injuries are devastating and management is complex. Treatment involves a multidisciplinary approach. Primary reconstruction involves nerve repair, grafting, and transfer techniques. Secondary reconstruction includes microneurovascular free-functioning muscle transfer, tendon transfers, and arthrodesis to improve or restore function. These procedures are indicated when patients present more than 12 months from injury or when primary reconstruction procedures fail, and should focus on elbow flexion and shoulder stability. A free-functioning muscle transfer is often indicated for elbow flexion, with double free-functioning muscle transfers providing possible prehension. Shoulder reconstruction focuses on restoring stability to the glenohumeral joint and restoring abduction. This article outlines these techniques, their principles, and important details.

Original languageEnglish (US)
Pages (from-to)51-64
Number of pages14
JournalNeurosurgery clinics of North America
Issue number1
StatePublished - Jan 1 2009


  • Brachial plexus injury
  • Free-functioning muscle transfers
  • Late reconstruction
  • Tendon transfers

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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