Brachial Plexus Injuries

Question 1

2 types of injuries?

Answer 1

Erbs (C5-6)

Klumpkes (C7-8T1)

Expected recovery except with unrepaired total tear.

Question 2

For erbs injuries, when is prognosis best?

Answer 2

If biceps is greater than fair grade by 3 mo.

Question 3

Primary and Secondary impairments of injury?

Answer 3

P: paralysis/ sensory loss

S: posture/contracture
Substitutions
Sublux/dislocate of GH and radial head
Deformity/poor bone growth

Question 4

How to Assess BPI?

Answer 4

Sensation (look at face reaction)
ROM (dissociation)
Muscular activity

Question 5

Aspects of muscle activity?

Answer 5

Spontaneous+ Posture
Reflexes
Waiters tip
Trumpeters sign
EMG activity.

Question 6

Tx of brachial plexus injuries?

Answer 6

Daily ROM
Stimulate muscle activity: GE/ isometric-ecc/ WB at shoulder
Prevent learned nonuse/deformities
Train functional mvmt.
Stimulate motor milestones

Question 7

Surgery for Brachial Plexus injuries?

Answer 7

Microsurgery to repair
Release/transfer tendon
Osteotomy
Humeral Fusion