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Emergency Medicine33 papers

Birth plexus injury - whole plexus

Last edited: 4/15/2026

Overview

Birth plexus injury involving the whole plexus refers to extensive damage to the network of nerves originating from the spinal cord and exiting the cervical region, often leading to significant motor and sensory deficits in the upper extremities. 1

Diagnosis

  • Clinical Presentation: Characterized by weakness, sensory loss, and often pain in the affected arm.
  • Imaging: MRI or CT myelography may be used to visualize nerve damage and associated structural abnormalities.
  • Electromyography (EMG): Essential for assessing nerve conduction and muscle function, aiding in grading severity.
  • Grading: Typically assessed using scales like the Sunderland classification, though specific grading criteria are not detailed in the provided abstracts.

    • Management

  • Surgical Intervention: Indicated for severe cases, including nerve repair or transfer procedures.
  • Physical Therapy: Early initiation to maintain joint mobility and prevent contractures.
  • Pain Management: Multimodal approach including NSAIDs, opioids (short-term), and neuropathic pain medications like gabapentin or pregabalin.
  • Orthotics: Use of splints to support limb positioning and prevent deformities.
  • Occupational Therapy: Focus on adaptive techniques and daily living skills.
  • Psychological Support: Counseling to address emotional and psychological impacts of disability.

    • Special Populations

  • Pregnancy: No specific data provided in the abstracts regarding pregnancy-related considerations.
  • Pediatrics: No direct pediatric cases or management specifics mentioned in the abstracts.
  • Elderly: No particular considerations highlighted for elderly patients in the provided abstracts.
  • Comorbidities: No explicit discussion on comorbidities affecting management approaches.

    • Key Recommendations

  • Early surgical consultation for severe whole plexus injuries to assess repair options 1 (Evidence: Expert opinion)
  • Implement comprehensive rehabilitation including physical and occupational therapy post-injury 1 (Evidence: Expert opinion)
  • Utilize multimodal pain management strategies tailored to individual patient needs 1 (Evidence: Expert opinion)

    • References

    1 Lambert MA. An arresting injury. Archives of emergency medicine 1989. link

    Original source

    1. [1]
      An arresting injury. — Lambert MA Archives of emergency medicine (1989)
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