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Children's Hospital of Pittsburgh
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Children's Hospital of Pittsburgh

Treatment Options for Brachial Plexus Palsies

Time plays a major role in recovering from brachial plexus palsies. There are three main treatment options:

Baby getting checked out by a doctor1. Time and Close Observation

  • Your child visits our Brachial Plexus Clinic where our team watches them. These visits most often take place every three months.
  • In many infants, their nerves may recover completely in the first year of life. This allows them to use their shoulders, arms, and hands.
  • Outcomes are often better if return of function happens in the first three months, but every child is different.
  • Some kids don't recover much with time. In this case, our team works with your family to talk through other options, which may include reconstructive surgery.

2. Physical and Occupational Therapy for Brachial Plexus Palsies

  • Physical therapy can help keep upper limbs flexible. Our team begins this with home exercises or outpatient physical therapy.
  • Occupational therapists also help children become freer in their daily lives. Our team will follow your child to measure their gains in muscle strength.

3. Surgery for Brachial Plexus Palsies

Primary brachial plexus surgery

This surgery may help if meaningful muscle function doesn't come back in the first 3 to 12 months of life. Sometimes, function starts to return but then stops.

Our team will need to have regular check-ins with your child — about every 3 months — to assess their progress.

If they stop making progress and their level of function isn't ideal, we may recommend surgery.

In babies, doctors usually use primary surgery to:

  • Openly explore the brachial plexus nerves.
  • Remove any scarred nerves.
  • Replace scarred nerves with nerve grafts. The nerve grafts are often from your child's leg.

Secondary brachial plexus surgery

After primary surgery, we will evaluate your child. We may suggest a second surgery if we determine they haven't regained adequate function of the arm for daily living.

We may also consider secondary brachial plexus surgery for children who are too old (over 1 year) for primary surgery.

Secondary surgeries can include tendon transfers or bone rotations. They may help older kids with brachial plexus palsies use their arm better than before.

Contact the Brachial Plexus Clinic at UPMC Children's

To make an appointment or learn more about our program, call us at 412-692-8650.