Treatment Options for Brachial Plexus Injuries

Time plays a major role in the recovery from brachial plexus injuries. There are three therapeutic options:

• Time and observation: The team in Children's Pediatric Brachial Plexus Clinic will observe your child during his or her visits to the clnic, which will occur every three months. In infants, the injured nerves often recover completely over the first year of life, allowing full use of the shoulder, arm, and hand. Typically, if there is rapid return of function, then the outcome is better. After a year, if there is minimal improvement in function, sometimes there will be lingering losses in movement.
• Physical and occupational therapy: During the recovery period, physical therapy can be very helpful in keeping the upper limb flexible. The team in the Pediatric Brachial Plexus Clinic will initiate this therapy through home exercises or outpatient physical therapy. Occupational therapists also help children become more independent in their daily activities. At each visit to the clinic, your child will be followed closely to determine gains in muscle strength.
• Surgery: Surgery may be necessary if sufficient muscle function is not restored within a realistic time frame. Sometimes, if improvement occurs but stops, the surgeon may decide to explore the brachial plexus to see if there is something that can be done to improve function. Surgery done directly on the brachial plexus is typically done during the child's first year of life. Sometimes older children with brachial plexus lesions benefit from surgeries such as tendon transfers or bone rotation surgeries.