Brachial Plexus Birth Palsy

Surgery for infants may include:

Nerve repair and grafting

During this procedure, the pediatric surgeon repairs the brachial plexus nerve or removes the damaged portion of one or more of the nerves and replaces it with a healthy nerve.

Nerve transfer

This procedure involves the pediatric surgeon connecting a nerve with a different purpose to a nerve that is not working in order to restore movement and feeling. Connecting a working nerve, or part of a working nerve, to the nerve that is not working helps restore lost movement. The “donor” nerve feeds one of several muscles so that there is no loss of major function.

There are numerous types of nerve transfer options. Your pediatric surgeon will help determine which one is best for your child.

By age 2, a child has likely reached the limit of his natural recovery. At this point, a combination of therapy and surgery may be more effective.

Surgery Brachial Plexus Injuries

Surgery for toddlers and older children may include:

Tendon transfer

During this procedure, a pediatric surgeon moves a healthy muscle or tendon to the damaged area in order to help improve functions that are lost or weakened by an injury. For example, a muscle that allows us to bring our arms to our body can be moved to allow us to lift our arms above our heads or to our sides.

Humeral osteotomy

The pediatric surgeon cuts the upper arm bone and moves it to correct the position. In some children the forearm becomes contracted in a way that a child cannot turn his hands palm up or down. A similar surgery can be done on the forearm to help improve position and function.

Free muscle transfer

This procedure involves a pediatric surgeon transplanting an entire muscle, along with its nerve and blood vessels, from another part of the body into the arm. The transferred muscle, usually a lesser important leg muscle, is controlled by a living nerve and revived by local blood vessels.

Bone and joint surgery

These surgeries are used to reposition joints to enhance function. They are often used to treat the later effects of nerve injuries.