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CC BY-NC-ND 4.0 · Indian J Plast Surg 2014; 47(02): 191-198
DOI: 10.4103/0970-0358.138941
Review Article
Association of Plastic Surgeons of India

Recent advances in the management of brachial plexus injuries

Prem Singh Bhandari
Department of Plastic Surgery, Command Hospital (NC), Chandimandir Cantt, Panchkula, Haryana, India
,
Sanjay Maurya
1   Department of Plastic Surgery, Command Hospital (WC), Chandimandir Cantt, Panchkula, Haryana, India
› Author Affiliations
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Publication History

Publication Date:
26 August 2019 (online)

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ABSTRACT

Management of brachial plexus injury is a demanding field of hand and upper extremity surgery. With currently available microsurgical techniques, functional gains are rewarding in upper plexus injuries. However, treatment options in the management of flail and anaesthetic limb are still evolving. Last three decades have witnessed significant developments in the management of these injuries, which include a better understanding of the anatomy, advances in the diagnostic modalities, incorporation of intra-operative nerve stimulation techniques, more liberal use of nerve grafts in bridging nerve gaps, and the addition of new nerve transfers, which selectively neurotise the target muscles close to the motor end plates. Newer research works on the use of nerve allografts and immune modulators (FK 506) are under evaluation in further improving the results in nerve reconstruction. Direct reimplantation of avulsed spinal nerve roots into the spinal cord is another area of research in brachial plexus reconstruction.

KEY WORDS

Brachial plexus injuries - nerve grafts - recent advances - reimplantation of avulsed spinal nerve roots - selective nerve transfers
 

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