Left Brachial Plexus Neuroma and Nerve Grafts
This exhibit depicts the condition of an infant brachial plexus after a shoulder dystocia injury. Shoulder dystocia is an obstetric emergency in which the fetal anterior shoulder is trapped behind the mother’s pelvis during vaginal birth. This can cause stretching and rupturing of the ventral nerve roots, resulting in brachial plexus disruption. Pre-operatively, scar tissue has trapped the brachial plexus, and an extraforaminal C5-6 neuroma has developed around the ruptured C5 nerve root. Ruptured nerve roots are also present at C7, C8, and T1. This is surgically repaired by removing the neuroma, scar tissue, and injured brachial plexus trunks. Nerve grafts are then harvested from the legs and neck to reconnect the cervical nerve roots to the brachial plexus. Two bifurcated nerve grafts are used to repair the cervical plexus motor branch and C5 nerve root to the superior trunk divisions. C7 and C8 are each repaired to C6 utilizing two nerve grafts. C6 is then reconnected to the anterior and posterior divisions of the superior trunk with a bifurcated nerve graft.