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Surgery

Brachial Plexus and Peripheral Nerve Clinic

What surgical options are available to my child?

The need for surgery will be determined by your child’s neurosurgeon. Your child’s doctor may order imaging such magnetic resonance imaging (MRI) or nerve testing (electromyogram, nerve conduction studies) depending on the severity the injury and recovery time in order to choose the best treatment options. Common surgical interventions for brachial plexus injuries performed at Barrow at Phoenix Children’s include:

  • Neurolysis/ neuroplasty: remove scar tissue from around the nerves or compressing the nerves
  • Nerve grafts: using one’s own nerves, artificial or cadaver nerve tubes to create channels for new connections to grow through
  • Nerve transfers: transferring parts of functioning nerves to non-functional nerves to try and regain function
  • Tendon releases and or transfers: used when “nerve” surgeries do not take or are not an option to improve function
  • Muscle transfers
  • Joint and or limb reconstructions

When should my child have surgery?

Timing of the primary surgery to repair the nerves will be determined by your child’s neurosurgeon, but often takes place between 2-6 months after the injury in order to gain as much movement and strength back as possible. The nerves will react to surgery best during this timeframe and have a higher chance of reaching the muscles they are supposed to reach for nerve reconnection.

If surgery is put off for too long, your child may be at risk for:

  • Insufficient nerve recovery resulting in an arm becoming “stuck” in a position which prevents completion of normal every-day tasks
  • Incomplete growth of the arm
  • Differences in function and capability of the arm
  • Chronic pain

Following your child’s surgery

  • Your child’s arm may be placed into either a sling or a cast in order to allow the arm and the nerves, muscles and tendons to properly heal.
  • Your child’s surgeon will instruct you on how and when you should move your child’s arm.
  • You and your child will be scheduled to attend follow up visits with the surgeon and your therapists in order to assess healing progress.
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