Literature Review of Surgical Treatment of Brachial Plexus Palsy

Brachial plexus palsy is a neuromotor flaccid paralysis secondary injury to any nerve root of the brachial plexus palsy. It typically occurs as an obstetric complication or trauma later in life. To treat these injuries, surgery became more common in the early 1900s, though it was later avoided due to poor results and morbidity. Still, conventional surgical techniques are being renewed. This includes nerve transfers, nerve grafting, muscle transfers, free muscle transfers, and neurolysis of scar around the brachial plexus in incomplete lesions. Overall, these techniques are indeed effective for partial injuries. Nerve transfer is particularly effective for brachial plexus palsy. In addition, intraplexal nerve surgery may be more effective than extraplexal for upper brachial plexus injuries. Distal SAN-to-SSN (spinoscapular) direct nerve transfer is also a reliable alternative, if patients do not desire other techniques. However, other issues like health care access and education are critical to patient outcomes.