Expectations

Written by Dr Richard Lawson FRACS - Hand Surgeon

What can be expected after repair of brachial plexus injuries?

Any return of function takes many months, as the nerves need to grow down from the repair site to the muscles, and this happens at less than a millimetre a day.

This period of waiting can be frustrating for the patient. During this time attempts to actively exercise the arm muscles are unproductive, but physiotherapy to maintain the range of motion of the joints is very important.

When the repaired nerve reaches the muscle and the muscle starts to contract the muscle can be exercised. At this point a slow but steady improvement in muscle strength usually occurs, over a period of many months. The muscle is never as strong as it was prior to the injury, but useful function can be obtained.

After surgical repair of a severe brachial plexus injury, movements of the shoulder and elbow flexion are usually most improved. In babies, hand movement is often regained, but this is not usual in adults.

It is common for other operations to be done at two to three years after injury to help improve function. This can involve stiffening joints that are not actively moving such as the wrist joint or rerouting tendons.