The brachial plexus, a structure composed of nerve roots located between the neck and the armpit, is responsible for innervating the upper limbs and for their sensitivity and motor skills (shoulders, elbows and hands).
Injury to the brachial plexus can occur due to partial or complete tearing or stretching of these nerve fibers that make up the plexus. In children, it most commonly affects newborns because of twisting or pulling movements during childbirth.
As a consequence, injury to this structure leads to paralysis (total or partial shoulder, arm, forearm and/or hands), changes in sensitivity and pain that can incapacitate the patient, in addition to the risk of muscle atrophy.
Types of brachial plexus injury
There are three types of brachial plexus injury; check out.
- Neuropraxia: This is the mildest form of nerve damage. Nerve conduction is interrupted, but axonal continuity is not lost.
- Axonal rupture: involves axonal degeneration, in which the continuity of the axon and its surrounding membrane (myelin) is relatively lost, but the connective tissue structure of the nerve is preserved.
- Nerve tear: Severe nerve injury where the nerve is completely severed by traction, bruising, or tearing. The most extreme form of neurotomy is transection, which causes enough damage to destroy the nerve's connective tissue as well as the axon and myelin sheath. In these cases, the recommendation of surgery is essential.
Treatment
For babies with plexus injuries (usually postpartum paralysis), they can and should undergo this surgery, which, when indicated, has a time window of 6 months. For this reason, babies must be monitored monthly from the first month of life until the decision of surgical need.
The procedure must be performed within this period because after surgery the nerve grows slowly, around 1 millimeter per day. Thus, the nerve after repair has to reach the muscle within 1 year after the injury.
Do you want to stay informed about this and other subjects related to pediatric physiotherapeutic care? Keep following my content and follow me on social media. redes sociais.
