[Basic principles and "direct nerve" reconstruction in brachial plexus paralysis].

Abstract

An exact knowledge of the complex anatomy of the brachial plexus is absolutely necessary to carry out this treatment. The most important diagnostic steps are: case history, examination, investigation of muscle function and sensitivity, myelo-CT, MRI, and neurophysiological investigations. The best time for operative revision is between the 6th week and the 3rd month. An individual therapy protocol must be established that includes a large spectrum of reconstructive options like nerve reconstructions, neurotizations, muscle and tendon transposition, muscle transplantation, arthrodesis, orthesis and others.