Nerve injury may affect your shoulders, arms, and hands when damage occurs in the brachial plexus, the network of nerves that travel from your cervical spine down to your fingers. An injury to this complex network needs the expertise of the team at Georgia Hand, Shoulder & Elbow in Atlanta, Athens, and Marietta, Georgia. Their orthopaedic surgeons and occupational therapists work together to provide the range of therapies and surgical procedures required to heal nerve injury of the brachial plexus.
Nerves may be injured by cutting, crushing, or stretching. Nerve injuries are often associated with another injury. For example, a laceration (cut) which injures a tendon may also cut a nerve. Fractures (broken bones) may stretch nerves and injure them.
Brachial plexus injuries (injuries to the nerves as they leave the cervical spine and neck) can occur from a number of mechanisms. They occur as a result of falls, motor vehicle accidents, crossfit type of training exercises, and in sporting events. These injuries may require significant assessment and intervention to optimize outcome. We have extensive experience treating injuries above the collar bone (supra clavicular) and below the collar bone (infra clavicular) injuries to the brachial plexus.
Nerve injuries cause numbness and/or weakness. Numbness may be partial or complete depending on the severity of the injury. Nerves go to certain areas of the hand and arm, so numbness is in a specific area depending on which nerve is injured. Similarly, weakness depends on the specific nerve which is injured. Not all nerves provide both functions. Therefore, a nerve injury may cause only numbness or only weakness. Nerve injuries can also be painful.
The majority of nerve injuries can be diagnosed by physical examination. An assessment of muscle strength and sensation is usually all that is required. Special testing is sometimes used but is more commonly obtained when evaluating the recovery of an injured nerve. It is common to diagnose a nerve injury and then follow recovery after treatment without any special testing.
In our center, we can make referrals for specialized neurophysiologic testing. Our occupational therapists have significant experience with the therapy modalities, bracing and other methods of treatment that are often required by patients with significant nerve injury. While exploration and repair may be necessary, newer methods of surgical treatment such as nerve transfer may improve outcome for certain patients. Nerve transfers are surgical procedures that use a working nerve to replace the function of a nerve that doesn’t function properly. They require optical magnification and fine microsurgical tools to be performed properly. These procedures can often be done as an outpatient procedure and can often be associated with significant improvement in limb function. Because the nature of these procedures is complex they often require the presence of two surgeons that have experience in the care of these difficult injuries.