Department of Plastic surgery at Apollo First Med Hospital specialises in all kinds of Plastic reconstructive surgeries especially Hand surgeries and Microsurgery. The department is known for treating Brachial Plexus complexities through peripheral microsurgical nerve surgeries especially Brachial plexus surgeries. Brachial plexus are a group of nerves that originate in the cervical spine and crisscross with each other in the neck and go down the arm. Injury to the brachial plexus leads to partial or complete paralysis of the limb.
Tamil Nadu has a distinction of being a state with very high road accident fatalities and many more of them being permanently disabled due to injuries like brachial plexus injuries. Majority of the patients are young adults either college going students or in their early stages of their career. A paralysed dominant hand and arm prevent them to go back to the regular work and studies. Apart from the paralysis, some patients develop severe constant excruciating pain preventing them from even carrying out their daily activities. These patients also suffer from depression and other psychological problems.
In a road traffic accident, Brachial Plexus Injury is often missed or wrongly diagnosed as the accident victims most of the time have other serious injuries to the Brain, Spine and chest. The focus is more to save the life of the accident victim. An accident victim if diagnosed to have injured brachial plexus, early referral to Reconstructive Plastic Surgeons followed by complex microsurgical nerve reconstruction within 2 to 6 months is crucial for good functional recovery.
Brachial plexus disorders is also caused during childbirth affecting new-borns. Injuries of the brachial plexus may be mild, with only temporary sequelae (a condition caused by an injury), or devastating, leaving the child with a drooping, insensate arm. Severity depends on the number of nerves involved and the degree to which each spine nerve is injured.
Speaking during the conference, Prof. R. Venkataswami, (Head and Senior Consultant), Apollo First Med Hospitals highlighted, “There is lack of awareness regarding brachial plexus injuries and treatment. If the patient is not treated within the golden period of between 3months to 6 months following injury, other secondary procedures will only give to sub optimal results.”
Unlike adults, brachial plexus injury in children affects the growth and development of the limb and usually the affected side is smaller than the opposite side. Elaborating on the Brachial Plexus surgery, Dr. V. Purushothaman, (Senior Consultant Plastic Surgeon) Apollo First Med Hospitals, said, “Unlike other surgeries, recovery from Brachial Plexus surgery takes more time to recover. In accident victims, the recovery of muscles and function is slow and takes at least 2-3 years of dedicated and regular physiotherapy to revive full hand functions. In Paediatric Brachial Plexus injury when spontaneous recovery in Children is often poor, early surgery within 4-6 months of age is essential for good results. We have seen over 200 Paediatric Brachial Plexus cases in the last 5 years” added
In last few decades, there have been many significant advancements in Brachial plexus management mainly due to better understanding of the nerve growth and newer techniques. Complex newer microsurgical nerve by-pass techniques similar to that of cardiac bypass is possible nowadays, where we can assure near normal recovery in partial injuries of brachial plexus. In complete injuries of brachial plexus the consensus is still evolving regarding the best way to manage these patients, this conference will be a platform for the specialists to share knowledge and discuss further advancements in the treatment.
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