| The nerves of the brachial plexus can oftentimes recover from injuries such as Erb's palsy. Infants less than a year old are capable of regenerating nerves at a rate of approximately one inch per month. If an infant can bend an elbow using its bicep by the third month, it is a good indicator of likely recovery. Even better indicators include wrist movement and digit extension. These signs point to spontaneous improvement. Sometimes the nerves do not fully reattach at their original motor and sensory targets. These patients may have significant limitation of movement, poor range of motion, weak muscles, or diminished sensation in the affected arm. EMG and MRI testing may be needed to identify the location and severity of the nerve damage. Patients with neurapraxia, the stretching of nerves without tearing, often recover 90-100% of function spontaneously. Neuroma, the formation of scar tissue around nerve injuries, must be relieved by surgery, and the prognosis varies depending on the damage. Surgical repair of damaged nerves must be performed within the first year to year and a half. For more severe injuries like avulsion and rupture, surgical repair must be done in a timely fashion, or full recovery is unlikely. Some surgical procedures to repair nerves include:
- Neurolysis – The surgical removal of scar tissue constricting the nerve.
- Neuroma excision – The complete removal of a neuroma, and the re-attachment of the nerve endings.
- Nerve grafting – Using nerve tissue grafts to bridge gaps between nerve ends.
- Neurotization – Using parts of donor nerve roots to repair an avulsion.
There are also a number of additional surgeries that can be performed to improve the function of the arm if the nerves never fully recover. Unfortunately, some patients will be impaired for the rest of their lives. It is important to help children keep joints limber to avoid contracture. Children can be taught to adapt in order to minimize deficits and maximize capabilities. Above all, parents can offer encouragement and support. If you believe your child has suffered irreversible brachial plexus injury, contact our law firm today. We can determine if the medical staff in the delivery room followed the proper procedures or were negligent in their duties. |
