Clinical problem-solving: brachial plexus closed injury and reconstruction.
OBJECTIVE
Current management of severe brachial plexus injury has undergone recent modifications, and surgical options have expanded.


METHODS
The case of a man with a severe closed brachial plexus injury resulting from a motorcycle accident is presented. The patient is found to have upper root avulsions that deprive him of function in the proximal arm.


RESULTS
Pre-, intra-, and postoperative decision making is reviewed by an expert in peripheral nerve surgery. Attention is paid to both diagnosis and management. A brief review of the literature pertaining to these points follows.


CONCLUSIONS
The recent expansion of surgical options for the management of severe brachial plexus injury has introduced significant controversy into this field.
Ranalli
Nathan J
NJ
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Kline
David G
DG
McGarvey
Michael L
ML
Boulis
Nicholas M
NM
Zager
Eric L
EL
D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D016067:Nerve Transfer / Q000379:methods; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*