Correction of such injuries
View(s):Grafts or transfers are the answers to obstetric brachial plexus injuries. In a grafting procedure, surgery is performed to remove the non-functional or damaged part of the nerve and a graft taken from the baby’s legs without affecting the functioning there, introduced to bridge the gap in the upper limb, according to Dr. Beneragama.
Surgical technique - Nerve transfers
However, in cases where the nerve damage is serious, a nerve transfer is performed, that too under anaesthesia, it is learnt. “For a transfer, depending on the severity of the injury, ‘a donor nerve’ could either be obtained from some part of the body, the other normal limb or the chest without affecting that area or from the affected limb itself,” says Dr. Beneragama, adding that the operation could last six to eight hours.
Being a very sensitive procedure, it would have to be handled with much skill and expertise, MediScene understands, while regular follow-ups and exercises under an occupational therapist are essential along with monitoring by the Plastic Surgeon. In the case of children who present with such injuries quite late with shoulder, elbow and hand issues, not having recovered fully, the disability would have to be assessed and a call made whether late reconstructive surgery should be performed, adds Dr. Beneragama.
Here the Plastic Surgeon will once again work in tandem with the occupational therapist as intensive exercises would be needed.