BRACHIAL PLEXUS INJURY

Assessment and Treatment of a Brachial Plexus Injury

Assignment: Assessment and Treatment of a Brachial Plexus Injury

Brachial Plexus Injury

The brachial plexus is a set of anterior cervical ventral nerve branches C5 - C6 - C7 - C8 and D1, and give rise to most of the nerves that control the movement of the upper limbs composed of arms, forearms and hands (Chung et al., 2011). The brachial plexus is a fragile nerve network and can be damaged by compression, stretching or direct trauma with rupture or nerve section. Stretch injuries occur when the head and neck are separated shoulder violently, as may occur in a motorcycle crash or a fall from a height at arm's length. If the fall occurs from a significant height, it not only breaks nerves but also bones. Compression injuries occur by crushing the nerves of the brachial plexus against the first rib, direct compression of neighbouring tumours or other structures (Gilbert, 2001).

Brachial plexus injury can be very mild as in the case of stretching or compression injury. It can also be very serious if the brachial plexus nerves become broken. This injury may lead to paralysis of the upper limb in severe cases. In addition, Brachial plexus injuries may be permanent as in the case of a completely severed nerve, or it may resolve spontaneously in case of inflammation. Severe cases of brachial plexus injury may require surgery, while the effectiveness of treatment depends on the severity and location of the brachial plexus injury (Gilbert, 2001).

Brachial plexus injury is one of the most severe and adverse prognostic disease of the peripheral nerves. The severity of this disease for the patient due to disability, pain, cosmetic defect, reduced social adaptation. The common mechanisms of brachial plexus injury are (Chung et al., 2011):

Blow shoulder body with supply of kinetic energy of a solid object, which in turn leads to a tension between the trunks of the clavicle, the intervertebral foramen and the head of the humerus. If rupture occurs, distal stems out of the trunks of the intervertebral foramen, the prognosis for functional recovery of the hands is quite favourable, and if we are dealing with preganglionic margin, then, unfortunately, the recovery is not going to happen (Cantu, 2013).

A fall from a low height is traction on the arm as a result of damage to the trunks of their tension between one rib, clavicle and the humeral head. Such injuries often lead to preganglionic injury, so in terms of more favourable prognosis.

Traction damage from blows to the vector directed from the top down on the shoulder. In this situation, the prognosis depends on the strength of the blow.

Damaged trunks of brachial plexus piercing - edged objects.

Damaged trunks of the brachial plexus in the gunshot and mine-blast injuries.

Anatomy

The anatomy of the brachial plexus is complex and subject to many anatomical variations. Nevertheless, a reminder is needed to understand anatomical therapeutic strategies. The brachial plexus is the meeting of the anterior branches of the last four cervical nerves (C5, ...