Treatment of Brachial Plexus Injury

Treatments, Rehabilitation, and Recovery
admin
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Treatment of Brachial Plexus Injury

Post by admin »

By a motorcycle accident in Aug. 2000 my left brachial plexus was injured and the C-8-nerve root was torn out of the spine. I was not able to move any part of my arm at first. As some function returned back into the hand and arm, the neurosurgeon advised not to operate the brachial plexus, at least as long as further function is returning. Indeed some muscles begin to work again. Yesterday I consulted a specialist in Hannover and asked him on the possibility of operating my arm (esp. the deltoideus muscle which still doesn't work) so I would perhaps be able to lift it up again. He told me that almost all other functions, e.g. to be able to move the elbow etc. can be operated successfully except for this one. He adviced me not to give up hope and keep on training as much as possible as the only thing I can do in this case. Well, It'll be already great if he would be able to "repair" my elbow function - what he promised me.
Also my hand is tingling permanently since the accident. I always hope that someday it stops tingling but up to now - no change at all.
Does anybody know, if anything else can be done to be able to lift up the arm again one day? Maybe they have just no idea here in Germany? :-)

Looking forward to any reply. Nicole
Joy in FL
Posts: 357
Joined: Sun Nov 04, 2001 8:36 pm
Location: Georgia

Re: Treatment of Brachial Plexus Injury

Post by Joy in FL »

Hello Nicole,

I just wanted to say hello and welcome. I wish I could offer some sort of information, unfortunately I can't. I live in the United States and have not seen a "specialist" in over 5 years. I also have the tingling in my hand. Some days are worse than others, at times there are certain fingers that are worse than others.

Wish I could be more helpful.

Joy
Joy in FL is now living in Georgia!
Left TBI on October 31, 1991
Ilsphid
Posts: 10
Joined: Wed Jul 10, 2002 7:23 pm

Re: Treatment of Brachial Plexus Injury

Post by Ilsphid »

I'm sure many people on here know better than me as I've only consulted with 2 neurologists..

Your doc is right, if youre healing naturally, go that route until there is no more progression at least.. my dr is not very fond of surgery for the condition im in at least(95%+ mobility, just pain and numbness/tingling); he said that depending on the situation is can be sucessfull 60% of the time and that is optimistic; going into the BP can cause more damage for some people than they started with. Taking out a cervial rib or something is one thing, but exlporatory surgery to find something and re-attach it is pretty dangerous.

plus nerves in general heal slowly to not at all; progress is very very slow even after surgery - some people feel great afterwards but then 'get worse' again... my guess it has more to do with all the postop painkillers ;)


John K
Posts: 108
Joined: Sat Nov 03, 2001 7:06 pm

Re: Treatment of Brachial Plexus Injury

Post by John K »

Hey

Im tbpi left aug 99. I have no return at all. I have intense tingling in my hand as well. Some days are better than others. You are lucky to have the recovery you have seen so far. I would suggest Dr Simon Kay in England is one of the top drs in Europe. Dave M, a poster on these boards, has seen Dr Kay and speaks highly of him. Also check out this site for Trauma Bpi's a lot of people there are in England and have a better knowledge of the physiscians that are in your area.

http://tbpiukgroup.homestead.com/index_1.html
jennyb
Posts: 1183
Joined: Fri Nov 02, 2001 5:24 pm
Injury Description, Date, extent, surgical intervention etc: January 1980 Yamaha RD200 vs 16 wheeler truck, result, 1 totally paralysed right arm. I was 21, now 54. I had no surgery, I don't regret this. Decided to totally ignore limitations (easily done aged 21) adapted very quickly to one handed life, got married, had 3 kids, worked- the effect of the injury on my life (once the pain stopped being constant) was minimal and now, aged 54, I very rarely even think of it, unless I bash it or it gets cold, then I wish I'd had it amputated :) Except for a steering knob on my car, I have no adaptations to help with life, mainly because I honestly don't think of myself as disabled and the only thing I can't do is peel potatoes, which is definitely a good thing.

Re: Treatment of Brachial Plexus Injury

Post by jennyb »

Hi Nicole. I'm wondering what electrical diagnostic work you've had done-is the nerve to the deltiod intact and firing? If it is, then you may well get some more return of functional movement there. Very few tbpi people get full return of function, even the more fortunate cases have some deficit.
The tingling in your hand is probably due to the C8 root damage, this kind of sensation seems to be associated with unresolved avulsion of the lower roots of the plexus. I get it too and I got my bpi 22 years ago! It has got less aggravating over time. There is a tingling associated with the recovery of the damaged nerves, but that starts at the site of injury and travels down.

Don't hesitate to get some more medical opinions if you're not happy with what your specialist says. Check the medical resources page which is linked to the home page of this site and see if there are any other specialists in Germany. If you want to chat with a lot of people with bpi injuries from Europe (and elsewhere) please go to the site linked by John in the post above. And keep up the physiotherapy!
admin
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Re: Treatment of Brachial Plexus Injury

Post by admin »

I have a brachial plexus injury from a nerve block I was given before my rotator cuff surgery. I go to Pt. for my shoulder and OT. for my arm and hand. I have had the EMG and MRI and all the other run around. I would love to hear from someone that has had bpi from a nerve block.It seems to be rare but I am really having problems with my hand and wrist. Is there a light at the end of the tunnel????
admin
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Re: Treatment of Brachial Plexus Injury

Post by admin »

Hi again,

5 weeks ago I was operated in Hannover by Dr. Rühmann, an orthopaedist who has specialized on muscle transfers. He made a "transfer of forearm muscles according to Steindler" to restore my elbow flexion in combination with a "rotation osteotomy" of my upper arm, which means he turned my arm 45° so that my forearm doesn't hit my thorax anymore when it is in flexion.

I think he did a real good job! At the moment I'm still wearing a gilchrist bandage (until 6 weeks post surgery) but I can feel the muscles working even now! He promised me an active elbow flexion of at least 90°!!! Hope he is right but I have a good feeling! Yesterday I took my arm out of the bandage and was able to keep it in 90° flexion!!! Isn't that great???

Has anyone had some kind of muscle transfer surgery?

athos

Re: Treatment of Brachial Plexus Injury

Post by athos »

Well it's really good to hear that ur surgery went so well. Sounds like they did a very good job.
I had tendon transfers as well over 2 years ago now by Mr Carlstedt of RNOH in uk. Results for me were really good too. I had finger and wrist extension restored. A very good surgery for me too, as the doc. said it would be before he operated me.
admin
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Re: Treatment of Brachial Plexus Injury

Post by admin »

Hello,
My brother has this injury which happened due to a motorcycle accident, he has perfect function of his hand but cannot lift his arm up atall or bend his elbow and he is in constant pain, the accident was about 4 years ago.
Can anybody advice, has it been to long ago now for my brother to have some sort of surgery.
Anyone advice would be most appreciated.
Thank's
lee.
John K
Posts: 108
Joined: Sat Nov 03, 2001 7:06 pm

Re: Treatment of Brachial Plexus Injury

Post by John K »

Hey Lee

I think muscle transfer surgery can be done anytime. They harvest a good muscle from the leg usaully and implant it into your arm. I think it must still have have a good nerve to fire it which could be tranfered from somewhere else. Dr. Nath recommended this for me and. In my case my whole arm is flail so i cant see going through all that for a bending elbow. But if the rest worked it would be well worth the effort.

John K
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