Brachial plexus injuries

Throughout most of its history, the surgical management of brachial plexus injuries was associated with much pessimism and was not advocated. A greater understanding of the processes of nerve healing and the development of surgical techniques to manage nerve injuries has contributed to better outcomes. More recently, the advent of microsurgical technique and the availability of finer instrumentation and suture material has led to greater technical precision and optimal healing in peripheral nerve surgery. This article reviews the history of brachial plexus surgery and the development of current surgical treatment. The mechanisms of injury and methods of diagnosis and evaluation of plexus injuries are discussed. Finally, management options, surgical techniques, and postoperative management and outcomes are described.