In traumatic brachial plexus palsy you can only achieve functional outcomes using microsurgical reconstruction of the plexus.
Microsurgical reconstruction is the only solution to obtain a good functional result in this type of injuries. Superior area arm paralysis has a good functional prognosis; arm involvement paralysis could require multiple procedures.
Vascular, bony or joint injuries must be assessed urgently. Deferred nervous injuries are treated in a three months period. Traumatic Brachial Plexus neural injury repair is not considered an emergency, with the exception of open wound injuries, when diagnosis is done in war area or hostile environment.
C8-T1 inferior roots medullary reimplantation for hand reconstruction doesn’t offer as good results as urgent surgery could justify.
Surgical procedure goal is achieve bone, joint and vascular associated injuries reconstruction. In the same way, microsurgical reconstruction of brachial plexus injury search for symmetrical results as in contralateral arm in superior area, and most functional result involving hand in total paralysis.
Physiotherapy and psychological support.
Reinnervation term in adult injuries is long, so it is necessary to maintain joint movement, prevent stiffness and electro-stimulate muscles groups to guarantee best condition metabolism.
Professional support is required for personal and psychological motivation, and execute joint and neurological treatment guides.
Traumatic Brachial Plexus Injury patient must get along with normal and fully functional limb memory. Injury leads to a long term reduction in abilities, as well as regression in work and personal expectations. Psychological support in these patients is essential.