What is brachial plexus? The brachial plexus is a network of nerves that begins at the spinal cord and delivers messages from the brain to the shoulder, arm and hand. Since many people don’t know much information about this part of the body, caregivers often find themselves asking: what is a brachial plexus injury? 

Brachial plexus injuries happen whenever nerves get stretched or injured. This typically happens during childbirth. A baby’s shoulders may become wedged within the birth canal. This causes nerve injury to the baby as they are being delivered. When the nerves are injured, it can impact the hand, wrist, elbow and shoulder. 

As we get older, it’s also possible to injure our brachial plexus by playing sports or after being involved in an accident. It is important to treat these types of injuries, especially if you notice symptoms in a younger child. Left untreated, it can result in lifelong problems. 

Symptoms of a brachial plexus injury may depend on your child’s age 

In infants, the most common symptoms of a brachial plexus injury include not being able to squeeze your finger, bend their wrist, bend or straighten their elbow, or raise their arm. Older children might be able to move their hand but have trouble moving their shoulder or elbow. Other kids may not be able to feel or move either arm or hand. While all of these are indications of a brachial plexus injury, a child’s age and the extent of the injury play a major role in determining treatment options. 

At Gillette Children’s, we have a team of specialists who can make a diagnosis and create a tailored treatment plan for your child and their specific needs. Early intervention is crucial for reducing long-term effects and the need for surgery. 

Certain testing is used to confirm a diagnosis 

When you come to Gillette Children’s, your child will receive a full evaluation. Certain tests can be used to help diagnose a brachial plexus injury, as well as determine its extent and severity. 

An Electromyogram (EMG) test use electrodes to track electrical activity within the muscles and nerves. Medicine or nitrous oxide is used to help your child feel more comfortable during the test. A Magnetic Resonance Imaging (MRI) scan uses magnets, invisible radio waves and computers to take a detailed picture of the inside of the body. This way, doctors can see bones, tendons, blood vessels, tissues and organs. 

Computed Tomography (CT) scans can also be used to look specifically at the shoulder joint. X-ray equipment takes pictures of the organs, bones, soft tissues and blood vessels. An ultrasound can also be used to do this as well. 

Proper treatment is critical 

After your child’s healthcare provider comes back with a brachial plexus injury diagnosis, it’s time to determine treatment. Therapeutic treatment is most effective for babies between the age of 3 to 6 months. Occupational therapy is useful for slightly older children, and it gives them a better chance at regaining the full use of their arm and hand. 

While therapy is our first course of action, in certain circumstances, surgery may be necessary. Brachial plexus surgery combined with postsurgical therapy can improve motor and sensory function. Depending on your child’s condition, it might make sense to implant nerve guides, perform nerve grafts or perform neurolysis to increase input to muscles. Nerve transfer surgery may also be recommended to bring an uninjured nerve to the area of nerve injury.  

For children who don’t regain motor function, have severe brachial plexus injuries or have injuries that were left untreated for too long, our orthopedic surgeons might need to correct bone, joint and muscle deformities.  

While this is complex, the team at Gillette Children’s is here to help your family through each step in the process. From initial testing to a confirmed diagnosis and treatment plan, you can rest assured that all of your questions will be answered in one place.