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ARM PARALYSIS SEEN IN ADULTS

Branches of five nerve roots coming through cervical spines form a complex network, and control all movements and sensation of upper extremity. We call this network of nerves ‘’Brachial Plexus’’.

Nerves give electrical stimulus to our muscles that provide our movements, and  touching sensation. When nerves are out of function and cannot transmit electrical impulses, movement in these muscles and/or  sensation is impossible.

Reasons of the arm paralysis may be motorcycle accidents, other type of traffic accidents, falls or any kind injuries. In closed injuries the patient is followed up for three months and some tests are run meanwhile. In some cases, although structural integrity of the nerve is not damaged nerve functions may lost for a certain period due to traction injuries. Recovery is observed in three months in most of these patients. Accompanying injuries such as bone fractures, vessel injuries are examined and should be treated prior to nerve surgery. Advanced radiological studies(MRI, Myelo CT...) are helpful to show whether the nerve is damaged and if it is, the level of injury. Electrophysiological studies help to show nerve transmission.

Operations performed immediately after diagnosis promise more successful results in nerve injuries. Nerves grow 1 mm daily from the repair site to the target. The closest targets from the repair site are shoulder and elbow, and movements  in these areas may restart in 6-12 months. Recovery in movements of the hand need very long time if not exist before the surgery. In most patients feeling in the hand comes back 1.5-2 years after surgery. Movements can obtained only in a small percentage of them because the muscles here cannot wait this very long period and  their structure change from muscle to connective tissue. Sensory nerves from legs are used to repair and replace the injured nerves of brachial plexus. Nerves taken from the legs are sensory ones which do not cause any movement failure. Scars in the legs after surgery should be ignored for arm functions.

One of the most important point that the patient and his/her relat

Branches of five nerve roots coming through cervical spines form a complex network, and control all movements and sensation of upper extremity. We call this network of nerves ‘’Brachial Plexus’’.

Nerves give electrical stimulus to our muscles that provide our movements, and  touching sensation. When nerves are out of function and cannot transmit electrical impulses, movement in these muscles and/or  sensation is impossible.

Reasons of the arm paralysis may be motorcycle accidents, other type of traffic accidents, falls or any kind injuries. In closed injuries the patient is followed up for three months and some tests are run meanwhile. In some cases, although structural integrity of the nerve is not damaged nerve functions may lost for a certain period due to traction injuries. Recovery is observed in three months in most of these patients. Accompanying injuries such as bone fractures, vessel injuries are examined and should be treated prior to nerve surgery. Advanced radiological studies(MRI, Myelo CT...) are helpful to show whether the nerve is damaged and if it is, the level of injury. Electrophysiological studies help to show nerve transmission.

Operations performed immediately after diagnosis promise more successful results in nerve injuries. Nerves grow 1 mm daily from the repair site to the target. The closest targets from the repair site are shoulder and elbow, and movements  in these areas may restart in 6-12 months. Recovery in movements of the hand need very long time if not exist before the surgery. In most patients feeling in the hand comes back 1.5-2 years after surgery. Movements can obtained only in a small percentage of them because the muscles here cannot wait this very long period and  their structure change from muscle to connective tissue. Sensory nerves from legs are used to repair and replace the injured nerves of brachial plexus. Nerves taken from the legs are sensory ones which do not cause any movement failure. Scars in the legs after surgery should be ignored for arm functions.

One of the most important point that the patient and his/her relatives should know about any kind of nerve surgery especially brachial plexus surgery is, a very long time is needed to get even some results. During this period active physiotherapy and rehabilitation should be performed patiently.

ives should know about any kind of nerve surgery especially brachial plexus surgery is, a very long time is needed to get even some results. During this period active physiotherapy and rehabilitation should be performed patiently.

As in all nerve injuries, operations that will be performed immediately after the diagnosis provides more successful results. Nerves grow by extending 1 mm rate daily from the repair area to downwards. While waiting function from shoulder and elbow muscles is possible, muscles that provide detailed hand movements are the farthest aims.  Reason for this is muscles that nerves will give electric turns into the connective tissue slowly and looses their contraction features irreversible.   If requirement for nerve operations is considered, it should applied before one year. In this term, how many nerve roots are damaged and their damage levels are important. For nerve roots that are damaged on spine level, transplantation from nerves that we use less may be required. In lower level injuries that nerve roots are visualized, nerves taken from legs are used by making bridge between the deficient region. Nerves taken from the leg are sensory nerves that do not cause any movement failure. Scars of the area that they are taken should be ignored for arm functions.

One of the most important points that the patient and patient relatives should remember related with either brachial plexus or other nerve operations is operations results will be taken after a long time. The purpose after this difficult treatment protocol that may last for years is to form a helper extremity that helps to the stable extremity by providing the maximum function in the arm and the hand (one hundred percent recovery and providing all functions should never be waited). But even this is possible with surgeries that will be performed in a long term, with a complying follow-up between the patient and the doctor and physiotherapy process and a big patience.

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