Courtesy of The Leeds Teaching Hospital
There is a range of injuries to the nerves (roots, trunks or divisions) that can be produces by traction.
A. Minimally stretched with no structural damage (neuraplexia).
In this injury the sensitive nerve fibers temporarily stop working but will rapidly recover without surgery.
B. Stretched but remains intact.
In this injury the nerve has been damaged but not torn apart. The nerves may recover to a variable degree on their own over a period of months and may not require surgical treatment
C. Nerve Rupture.
In this type of injury, the nerve has been stretched to breaking point and has been snapped or torn (similar to an overstretched elastic band). Ruptures will not heal without surgery.
D. Nerve Root Avulsion.
In this injury, the nerves are torn away from the spinal cord and cannot be re-joined to the cord. Some function of the arm will be permanently lost. At surgery, nerves may be transferred from other areas to improve function.
How do we establish what type of injury has occurred?
Initially you will be examined carefully to assess the movement and sensation you have in your arm. We may perform x-rays and scans (MRI scan, CT scan) to help in the diagnosis and to exclude other injuries that are associated with brachial plexus injuries. Whilst these tests are useful to aid diagnosis, often the true extent of the injury may only finally be determined by performing an exploratory operation.