To provide the best possible outcome to the patients with Brachial Plexus Injury by providing a combination of direct nerve surgery and surgery of the muscles and bones to make them near normal as possible or at least to make them lead independent lives.
Brachial Plexus is a network of nerves in the neck which help to carry impulses from the Brain to the structures of the hand. Five nerves which come out of the spinal cord (C5, C6, C7, C8, T1) join one another and branch to form the brachial plexus. Injury to them is called as Brachial Plexus injuries.
Brachial Plexus injuries occur in two groups of people – one during childbirth when the child suffers Brachial Plexus injury (Birth Brachial Plexus Palsy, commonly called as Erb's Palsy) and the other due to violent forces that occur in injuries like motor cycle accidents. The pathology, the philosophy of management and the outcome achieved are very different in both the groups. Hence they are dealt with separately.
This involves transfer of muscle from another part of the body (mostly gracilis muscle from the thigh) along with its blood vessels and nerves to the upper limb. The blood vessels supplying muscles are attached to similar vessels in the hand to make it survive. The nerve is attached to healthy motor nerve. This is a demanding procedure but could be the only answer when other options are not available.
(Success >80% have grade 4 or more power)
Brachial Plexus Palsy is a situation where we have to intelligently utilise available sources of muscle power in situations where they will be most useful. So for this, selective arthrodesis of joints like the wrist and thumb CMC jointscarried out. In cases where the long flexion are working proximal interphalangeal joint arthrodesis can be done so that the available power will be maximally utilised. Tendon transfers are procedures where the attachment of a tendon is transferred to another tendon so that it does a new job
The person who had total paralysis of upper limb has recovered flexion to the elbow by nerve transfers (spinal accessory through sural nerve graft). The lesion area has been arthrodesed to provide much suitable distal part before a free function muscle transfer to bend the fingers.
The lead team is well supported by a group of therapists who are very important to obtain optimal results and work in close co-ordination under one roof.
Necessary splints are manufacture in-house. The team has got a combination of Plastic Surgery and Orthopaedic Surgery skills such that all surgeries related to Brachial Plexus, Free Functioning Muscle Transfer to Arthrodesis of motor joints of the shoulder can be done by the same team.