Skip to main content
SpringerLink
Log in

Mechanisms of Injury

  • Chapter
  • First Online:
Operative Brachial Plexus Surgery

  • 1243 Accesses

Abstract

The leading cause of adult brachial plexus injuries is trauma resulting from a closed traction injury secondary to a high-velocity motor vehicle accident. Ninety percent of patients suffer supraclavicular lesions. A widened shoulder-neck angle at the time of injury with an adducted shoulder predisposes upper trunk injury, while shoulder abduction predisposes lower trunk injury. Penetrating open injuries, such as gunshot wounds and lacerations, are less common and usually result in infraclavicular injury with concomitant vascular injury. Glenohumeral dislocations and sports-related brachial plexus lesions also represent other causes of closed traction injuries. Nontraumatic brachial plexus injuries include iatrogenic injuries related to patient positioning and regional anesthetics, primary and metastatic brachial plexus tumors, and neuralgic amyotrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Aydn A, Tumerdem B, Yazar M, Erer M. Three-thousand-year-old written reference to a description of what might be the earliest brachial plexus injuries in the Iliad of Homer. Plast Reconstr Surg. 2004;114(5):1352–3.

    Article  PubMed  Google Scholar 

  2. Narakas AO. The treatment of brachial plexus injuries. Int Orthop. 1985;9(1):29–36.

    Article  CAS  PubMed  Google Scholar 

  3. Kim DH, Murovic JA, Tiel RL, Kline DG. Infraclavicular brachial plexus stretch injury. Neurosurg Focus. 2004;16(5):E4.

    PubMed  Google Scholar 

  4. Kaiser R, Waldauf P, Ullas G, Krajcová A. Epidemiology, etiology, and types of severe adult brachial plexus injuries requiring surgical repair: systematic review and meta-analysis. Neurosurg Rev. 2018;1:1–10.

    Google Scholar 

  5. Soldado F, Ghizoni MF, Bertelli J. Injury mechanisms in supraclavicular stretch injuries of the brachial plexus. Hand Surg Rehabil. 2016;35(1):51–4.

    Article  PubMed  Google Scholar 

  6. Kim DH, Murovic JA, Tiel RL, Kline DG. Mechanisms of injury in operative brachial plexus lesions. Neurosurg Focus. 2004;16(5):E2.

    PubMed  Google Scholar 

  7. Mihara A, Kanchiku T, Nishida N, Tagawa H, Ohgi J, Suzuki H, et al. Biomechanical analysis of brachial plexus injury: availability of three-dimensional finite element model of the brachial plexus. Exp Ther Med. 2018 Feb;15(2):1989–93.

    PubMed  Google Scholar 

  8. Li GY, Xue MQ, Wang JW, Zeng XY, Qin J, Sha K. Traumatic brachial plexus injury: a study of 510 surgical cases from multicenter services in Guangxi, China. Acta Neurochir. 2019;161(5):899–906.

    Article  PubMed  Google Scholar 

  9. Faglioni W, Siqueira MG, Martins RS, Heise CO, Foroni L. The epidemiology of adult traumatic brachial plexus lesions in a large metropolis. Acta Neurochir. 2014;156(5):1025–8.

    Article  PubMed  Google Scholar 

  10. Kim DH, Cho YJ, Tiel RL, Kline DG. Outcomes of surgery in 1019 brachial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg. 2003;98(5):1005–16.

    Article  PubMed  Google Scholar 

  11. Midha R. Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery. 1997;40(6):1182–8.

    Article  CAS  PubMed  Google Scholar 

  12. Terzis JK, Vekris MD, Soucacos PN. Outcomes of brachial plexus reconstruction in 204 patients with devastating paralysis. Plast Reconstr Surg. 1999;104(5):1221–40.

    Article  CAS  PubMed  Google Scholar 

  13. Jain DK, Bhardwaj P, Venkataramani H, Sabapathy SR. An epidemiological study of traumatic brachial plexus injury patients treated at an Indian Centre. Indian J Plast Surg. 2012;45(3):498–503.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kaiser R, Mencl L, Haninec P. Injuries associated with serious brachial plexus involvement in polytrauma among patients requiring surgical repair. Injury. 2014;45(1):223–6.

    Article  PubMed  Google Scholar 

  15. Bertelli JA, Ghizoni MF, Soldado F. Patterns of brachial plexus stretch palsy in a prospective series of 565 surgically treated patients. J Hand Surg Am. 2017;42(6):443–446.e2.

    Article  PubMed  Google Scholar 

  16. Barman A, Chatterjee A, Prakash H, Viswanathan A, Tharion G, Thomas R. Traumatic brachial plexus injury: electrodiagnostic findings from 111 patients in a tertiary care hospital in India. Injury. 2012;43(11):1943–8.

    Article  PubMed  Google Scholar 

  17. Kaiser R, Waldauf P, Haninec P. Types and severity of operated supraclavicular brachial plexus injuries caused by traffic accidents. Acta Neurochir. 2012 Jul;154(7):1293–7.

    Article  PubMed  Google Scholar 

  18. Socolovsky M, Antoniadis G, Lovaglio A, Durner G, Bonilla G, Schmidhammer M, et al. A comparison of patients from Argentina and Germany to assess factors impacting brachial plexus and brain injury. J Brachial Plex Peripher Nerve Inj. 2019;14(01):e39–46.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kaiser R, Haninec P. The influence of seatbelts on the types of operated brachial plexus lesions caused by car accidents. J Hand Surg Am. 2012;37(8):1657–9.

    Article  PubMed  Google Scholar 

  20. Brunelli GA, Brunelli GR. A fourth type of brachial plexus lesion: the intermediate (C7) palsy. J Hand Surg Br. 1991;16(5):492–4.

    Article  CAS  PubMed  Google Scholar 

  21. Zhong LY, Wang AP, Hong L, Chen SH, Wang XQ, Lv YC, et al. Microanatomy of the brachial plexus roots and its clinical significance. Surg Radiol Anat. 2017;39(6):601–10.

    Article  PubMed  Google Scholar 

  22. Sunderland S. Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder. J Neurosurg. 1974;41(6):705–14.

    Article  CAS  PubMed  Google Scholar 

  23. Mahan MA, Yeoh S, Monson K, Light A. Rapid stretch injury to peripheral nerves: biomechanical results. Neurosurgery. 2019;85(1):E137–44.

    Article  PubMed  Google Scholar 

  24. Yeoh S, Mahan MA. Brachial plexus stretch injury needs anatomical context. J Neurosurg Spine. 2019;14:1–2.

    Google Scholar 

  25. Lam WL, Fufa D, Chang NJ, Chuang DC. Management of infraclavicular (Chuang level IV) brachial plexus injuries: a single surgeon experience with 75 cases. J Hand Surg Eur Vol. 2015;40(6):573–82.

    Article  CAS  PubMed  Google Scholar 

  26. Milton GW. The circumflex nerve and dislocation of the shoulder. Br J Phys Med. 1954;17(6):136–8.

    CAS  PubMed  Google Scholar 

  27. Chuang DC. Brachial plexus injuries: adult and pediatric. In: Chang J, editor. Plastic surgery. 3rd ed. Elsevier; 2013. p. 789–816.

    Google Scholar 

  28. Chambers JA, Hiles CL, Keene BP. Brachial plexus injury management in military casualties : who , what , when , why , and how. Mil Med. 2014;179(6):640–4.

    Article  PubMed  Google Scholar 

  29. Kim DH, Murovic JA, Tiel RL, Kline DG. Penetrating injuries due to gunshot wounds involving the brachial plexus. Neurosurg Focus. 2004;16(5):E3.

    PubMed  Google Scholar 

  30. Ahmed-Labib M, Golan JD, Jacques L. Functional outcome of brachial plexus reconstruction after trauma. Neurosurgery. 2007;61(5):1016–22.

    Article  PubMed  Google Scholar 

  31. Samardzic MM, Rasulic LG, Grujicic DM. Gunshot injuries to the brachial plexus. J Trauma. 1997;43(4):645–9.

    Article  CAS  PubMed  Google Scholar 

  32. Kline DG. Civilian gunshot wounds to the brachial plexus. J Neurosurg. 1989;70(2):166–74.

    Article  CAS  PubMed  Google Scholar 

  33. Chen L, Peng F, Wang T, Chen D, Yang J. Traumatic pseudoaneurysm of axillary artery combined with brachial plexus injury. PLoS One. 2014;9(11):e113099.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. Secer HI, Daneyemez M, Tehli O, Gonul E, Izci Y. The clinical, electrophysiologic, and surgical characteristics of peripheral nerve injuries caused by gunshot wounds in adults : a 40-year experience. Surg Neurol. 2008;69(2):143–52.

    Article  PubMed  Google Scholar 

  35. Secer HI, Solmaz I, Anik I, Izci Y, Duz B, Daneyemez MK, et al. Surgical outcomes of the brachial plexus lesions caused by gunshot wounds in adults. J Brachial Plex Peripher Nerve Inj. 2009;4:11.

    Google Scholar 

  36. Kim DH, Murovic JA, Tiel RL, Kline DG. Lacerations to the brachial plexus: surgical techniques and outcomes. J Reconstr Microsurg. 2005;21(7):435–40.

    Article  PubMed  Google Scholar 

  37. Kaiser R, Ullas G. Acutely reconstructed isolated supraclavicular brachial plexus injury caused by a chainsaw. Plast Surg Case Studies. 2016;2(1):7–8.

    Article  Google Scholar 

  38. Levitz CL, Reilly PJ, Torg JS. The pathomechanics of chronic, recurrent cervical nerve root neuropraxia. The chronic burner syndrome. Am J Sport Med. 1997;25(1):73–6.

    Article  CAS  Google Scholar 

  39. Bohu Y, Klouche S, Lefevre N, Peyrin JC, Dusfour B, Hager JP, et al. The epidemiology of 1345 shoulder dislocations and subluxations in French Rugby union players: a five-season prospective study from 2008 to 2013. Br J Sport Med. 2015;49(23):1535–40.

    Article  Google Scholar 

  40. Kelly JD, Clancy M, Marchetto PA, Moyer RA. The relationship of transient upper extremity paresthesias and cervical stenosis. Orthop Trans. 1992;16:732.

    Google Scholar 

  41. Meyer SA, Schulte KR, Callaghan JJ, Albrigt JP, Powell JW, Crowley ET, et al. Cervical spinal stenosis and stingers in collegiate football players. Am J Sport Med. 1994;22(2):158–66.

    Article  CAS  Google Scholar 

  42. Castro FP Jr, Ricciardi J, Brunet ME, Busch MT, Whitecloud TS 3rd. Stingers, the Torg ratio, and the cervical spine. Am J Sport Med. 1997;25(5):603–8.

    Article  Google Scholar 

  43. Aval SM, Durand P Jr, Shankwiler JA. Neurovascular injuries to the Athlete’s shoulder: part I. J Am Acad Orthop Surg. 2007;15(4):249–56.

    Article  PubMed  Google Scholar 

  44. Shannon B, Klimkiewicz JJ. Cervical burners in the athlete. Clin Sport Med. 2002;21(1):29–35.

    Article  Google Scholar 

  45. Rihn J, Anderson DT, Lamb K, Deluca PF, Bata A, Marchetto PA, et al. Cervical spine injuries in American football. Sport Med. 2009;39(9):697–708.

    Article  Google Scholar 

  46. Daly C, Payne SH, Seiler JG. Severe brachial plexus injuries in American football. Orthopedics. 2016;39(6):e1188–92.

    Article  PubMed  Google Scholar 

  47. Hirasawa Y, Sakakida K. Sports and peripheral nerve injury. Am J Sport Med. 1983;11(6):420–6.

    Article  CAS  Google Scholar 

  48. Visser CP, Coene LN, Brand R, Tavy DL. The incidence of nerve injury in anterior dislocation of the shoulder and its influence on functional recovery. A prospective clinical and EMG study. J Bone Joint Surg Br. 1999;81(4):679–85.

    Article  CAS  PubMed  Google Scholar 

  49. DePalma AF. Surgery of the shoulder. Philadelphia: Lippincott; 1951.

    Google Scholar 

  50. Watson-Jones R. Fractures and joint injuries. Edinburgh: E&S Livingstone Ltd; 1952.

    Google Scholar 

  51. Gutkowska O, Martynkiewicz J, Urban M, Gosk J. Brachial plexus injury after shoulder dislocation: a literature review. Neurosurg Rev 2018 [Epub ahead of print].

    Google Scholar 

  52. Robinson CM, Shur N, Sharpe T, Ray A, Murray IR. Injuries associated with traumatic anterior glenohumeral dislocations. J Bone Joint Surg Am. 2012;94(1):18–26.

    Article  CAS  PubMed  Google Scholar 

  53. Travlos J, Goldberg I, Boome RS. Brachial plexus lesions associated with dislocated shoulders. J Bone Joint Surg Br. 1990;72(1):68–71.

    Article  CAS  PubMed  Google Scholar 

  54. Liveson JA. Nerve lesions associated with shoulder dislocation; an electrodiagnostic study of 11 cases. J Neurol Neurosurg Psychiatry. 1984;47(7):742–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Kosiyatrakul A, Jitprapaikulsarn S, Durand S, Oberlin C. Recovery of brachial plexus injury after shoulder dislocation. Injury. 2009;40(12):1327–9.

    Article  PubMed  Google Scholar 

  56. Stevens JH. Brachial plexus paralysis. In: Kreiger, editor. The shoulder: rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Melbourne. 1934.

    Google Scholar 

  57. McGregor AL. A synopsis of surgical anatomy. Baltimore: William Wood & Company; 1942.

    Google Scholar 

  58. Zoltan JD. Injury to the suprascapular nerve associated with anterior dislocation of the shoulder: case report and review of the literature. J Trauma. 1979;19(3):203–6.

    Article  CAS  PubMed  Google Scholar 

  59. Wehbe J, Maalouf G, Habanbo J, Chidiac RM, Braun E, Merle M. Surgical treatment of traumatic lesions of the axillary nerve. A retrospective study of 33 cases. Acta Orthop Belg. 2004;70(1):11–8.

    PubMed  Google Scholar 

  60. Razif MA, Rajasingam V. Anterior shoulder dislocation with axillary artery and nerve injury. Med J Malaysia. 2002;57(4):496–8.

    PubMed  Google Scholar 

  61. Stenning M, Drew S, Birch R. Low-energy arterial injury at the shoulder with progressive or delayed nerve palsy. J Bone Joint Surg Br. 2005;87(8):1102–6.

    Article  CAS  PubMed  Google Scholar 

  62. Regauer M, Polzer H, Mutschler W. Neurovascular complications due to the Hippocrates method for reducing anterior shoulder dislocations. World J Orthop. 2014;5(1):57–61.

    Article  PubMed  PubMed Central  Google Scholar 

  63. de Laat EA, Visser CP, Coene LN, Pahplatz PV, Tavy DL. Nerve lesions in primary shoulder dislocations and humeral neck fractures. A prospective clinical and EMG study. J Bone Joint Surg Br. 1994;76(3):381–3.

    Article  PubMed  Google Scholar 

  64. Martinoli C, Bianchi S, Santacroce E, Pugliese F, Graif M, Derchi LE. Brachial plexus sonography: a technique for assessing the root level. AJR Am J Roentgenol. 2002;179(3):699–702.

    Article  PubMed  Google Scholar 

  65. Takase F, Inui A, Mifune Y, Muto T, Harada Y, Kokubu T, et al. Concurrent rotator cuff tear and axillary nerve palsy associated with anterior dislocation of the shoulder and large glenoid rim fracture: a “terrible tetrad”. Case Rep Orthop. 2014;312968

    Google Scholar 

  66. Yeap JS, Lee DJ, Fazir M, Kareem BA, Yeap JK. Nerve injuries in anterior shoulder dislocations. Med J Malaysia. 2004;59(4):450–4.

    CAS  PubMed  Google Scholar 

  67. Visser CP, Tavy DL, Coene LN, Brand R. Electromyographic findings in shoulder dislocations and fractures of the proximal humerus: comparison with clinical neurological examination. Clin Neurol Neurosurg. 1999;101(2):86–91.

    Article  CAS  PubMed  Google Scholar 

  68. Gutkowska O, Martynkiewicz J, Stępniewski M, Gosk J. Analysis of patient-dependent and trauma-dependent risk factors for persistent brachial plexus injury after shoulder dislocation. Biomed Red Int. 2018;2018:14512137.

    Google Scholar 

  69. Fox M, Lambert S, Birch R. The terrible triad of the shoulder. J Bone Joint Surg. 2009;91-B(Suppl 1):13–20.

    Google Scholar 

  70. Uribe JS, Kolla J, Omar H, Dakwar E, Abel N, Mangar D, et al. Brachial plexus injury following spinal surgery. J Neurosurg Spine. 2010;13(4):552–8.

    Article  PubMed  Google Scholar 

  71. Duffy BJ, Tubog TD. The prevention and recognition of ulnar nerve and brachial plexus injuries. J Perianesthesia Nurs. 2017;32(6):636–49.

    Article  Google Scholar 

  72. Grant I, Brovman EY, Kang D, Greenberg P, Saba R, Urman RD. A medicolegal analysis of positioning-related perioperative peripheral nerve injuries occurring between 1996 and 2015. J Clin Anesth. 2019;58:84–90.

    Article  PubMed  Google Scholar 

  73. Brull R, McCartney CJ, Chan VW, El-Beheiry H. Neurological complications after regional anesthesia: contemporary estimates of risk. Anesth Analg. 2007;104(4):965–74.

    Article  PubMed  Google Scholar 

  74. Vlassakov K, Lirk P, Rathmell JP. Intraneural injection: is the jury still out? Anesthesiology. 2018;129(2):221–4.

    Article  PubMed  Google Scholar 

  75. Kapur E, Vuckovic I, Dilberovic F, Zaciragic A, Cosovic E, Divanovic KA, et al. Neurologic and histologic outcome after intraneural injections of lidocaine in canine sciatic nerves. Acta Anaesthesiol Scand. 2007;51(1):101–7.

    Article  CAS  PubMed  Google Scholar 

  76. Maruyama M. Long-tapered double needle used to reduce needle stick nerve injury. Reg Anesth. 1997;22(2):157–60.

    CAS  PubMed  Google Scholar 

  77. Jeng CL, Rosenblatt M. Intraneural injections and regional anesthesia: the known and the unknown. Minerva Anestesiol. 2011;77(1):54–48.

    CAS  PubMed  Google Scholar 

  78. Avellanet M, Sala-Blanch X, Gonzalez-Viejo MA. Permanent upper trunk plexopathy after interscalene brachial plexus block. J Clin Monit Comput. 2016;30(1):51–4.

    Article  PubMed  Google Scholar 

  79. Romanowski L, Reich H, McGlynn F, Adelson MD, Taylor PJ. Brachial plexus neuropathies after advanced laparoscopic surgery. Fertil Steril. 1993;60(4):729–32.

    Article  CAS  PubMed  Google Scholar 

  80. Shveiky D, Aseff JN, Iglesia CB. Brachial plexus injury after laparoscopic and robotic surgery. J Minim Invasive Gynecol. 2010;17(4):414–20.

    Article  PubMed  Google Scholar 

  81. Eteuati J, Hiscock R, Hastie I, Hayes I, Jones I. Brachial plexopathy in laparoscopic-assisted rectal surgery: a case series. Tech Coloproctol. 2013;17(3):293–7.

    Article  CAS  PubMed  Google Scholar 

  82. Gagnon J, Poulin EC. Beware of the Trendelenburg position during prolonged laparoscopic procedures. Can J Surg. 1993;36(6):505–6.

    CAS  PubMed  Google Scholar 

  83. Abdalmageed OS, Bedaiwy MA, Falcone T. Nerve injuries in gynecologic laparoscopy. J Minim Invasive Gynecol. 2017;24(1):16–27.

    Article  PubMed  Google Scholar 

  84. Unlu Y, Beliogu U, Hikmet K, Becit N, Ceviz M. Brachial plexus injury following median sternotomy. Interact Cardiovasc Thorac Surg. 2007;6:235–7.

    Article  PubMed  Google Scholar 

  85. Vahl CF, Carl I, Muller-Vahl H, Struck E. Brachial plexus injury after cardiac surgery. The role of internal mammary artery preparation: a prospective study on 1000 consecutive patients. J Thorac Cardiovasc Surg. 1991;102(5):724–9.

    Article  CAS  PubMed  Google Scholar 

  86. Healey S, O'Neill B, Bilal H, Waterworth P. Does retraction of the sternum during median sternotomy result in brachial plexus injuries ? Interact Cardiovasc Thorac Surg. 2013;17(1):151–7.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Chauhan A, Jacobs B, Andoga A, Baratz ME. Extensor tendon injuries in athletes. Sports Med Arthrosc Rev. 2014;22(1):45–55.

    Article  PubMed  Google Scholar 

  88. Lederman RJ, Breuer AC, Hanson MR, Furlan AJ, Loop FD, Cosgrove DM, et al. Peripheral nervous complications of coronary artery bypass graft surgery. Ann Neurol. 1982;12(3):297–301.

    Article  CAS  PubMed  Google Scholar 

  89. Bohsali KI, Wirth MA, Rockwood CA Jr. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(10):2279–92.

    PubMed  Google Scholar 

  90. Lenoir H, Dagneaux L, Canovas F, Waitzenegger T, Pham TT, Chammas M. Nerve stress during reverse total shoulder arthroplasty: a cadaveric study. J Shoulder Elb Surg. 2017;26(2):323–30.

    Article  Google Scholar 

  91. Kam AW, Lam PH, Haen PSWA, Tan M, Shamsudin A, Murrell GAC. Preventing brachial plexus injury during shoulder surgery: a real-time cadaveric study. J Shoulder Elb Surg. 2018;27(5):912–22.

    Article  Google Scholar 

  92. Nagda SH, Rogers KJ, Sestokas AK, Getz CL, Ramsey ML, Glaser DL, et al. Peripheral nerve function during shoulder arthroplasty using intraoperative nerve monitoring. J Shoulder Elb Surg. 2007;16(3 Suppl):S2–8.

    Article  Google Scholar 

  93. Ladermann A, Lubbeke A, Melis B, Stern R, Christofilopoulos P, Bacle G, et al. Prevalence of neurologic lesions after total shoulder arthroplasty. J Bone Joint Surg Am. 2011;93(14):1288–93.

    Article  CAS  PubMed  Google Scholar 

  94. Ladermann A, Williams MD, Melis B, Hoffmeyer P, Walch G. Objective evaluation of lengthening in reverse shoulder arthroplasty. J Shoulder Elb Surg. 2009;18(4):588–95.

    Article  Google Scholar 

  95. Jia X, Yang J, Chen L, Yu C, Kondo T. Primary brachial plexus tumors: clinical experiences of 143 cases. Clin Neurol Neurosurg. 2016;148:91–5.

    Article  PubMed  Google Scholar 

  96. Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg. 2005;102(2):256–66.

    Article  PubMed  Google Scholar 

  97. Kim J, Jeon JY, Choi YJ, Choi JK, Kim SB, Jung KH, et al. Characteristics of metastatic brachial plexopathy in patients with breast cancer. Support Care Cancer. 2019:2–7.

    Google Scholar 

  98. Cai Z, Li Y, Hu Z, Fu R, Rong X, Wu R, et al. Radiation-induced brachial plexopathy in patients with nasopharyngeal carcinoma: a retrospective study. Oncotarget. 2016;7(14):18887–95.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Yan M, Kong W, Kerr A, Brundage M. The radiation dose tolerance of the brachial plexus: a systematic review and meta-analysis. Clin Transl Radiat Oncol. 2019;18:23–31.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Lindberg K, Grozman V, Lindberg S, Onjukka E, Lax I, Lewensohn R, et al. Radiation-induced brachial plexus toxicity after SBRT of apically located lung lesions. Acta Oncol. 2019;58(8):1178–86.

    Article  CAS  PubMed  Google Scholar 

  101. Johansson S, Svensson H, Denekamp J. Timescale of evolution of late radiation injury after postoperative radiotherapy of breast cancer patients. Int J Radiat Oncol Biol Phys. 2000;48(3):745–50.

    Article  CAS  PubMed  Google Scholar 

  102. Stoll BA, Andrew JT. Radiation-induced peripheral neuropathy. Br Med J. 1966;1(5491):834–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Jia Y, Gou W, Geng L, Wang Y, Chen J. Anatomic proximity of the peroneal nerve to the posterolateral corner of the knee determined by MR imaging. Knee. 2012;19(6):766–8.

    Article  PubMed  Google Scholar 

  104. Seror P. Neuralgic amyotrophy. An update. Joint Bone Spine. 2017;84(2):153–8.

    Article  PubMed  Google Scholar 

  105. Tsairis P, Dyck PJ, Mulder DW. Natural history of brachial plexus neuropathy. Report on 99 patients. Arch Neurol. 1972;27(2):109–17.

    Article  CAS  PubMed  Google Scholar 

  106. Suarez GA, Giannini C, Bosch EP, Barohn RJ, Wodak J, Ebeling P, et al. Immune brachial plexus neuropathy: suggestive evidence for an inflammatory-immune pathogenesis. Neurology. 1996;46(2):559–61.

    Article  CAS  PubMed  Google Scholar 

  107. Pan YW, Wang S, Tian G, Li C, Tian W, Tian M. Typical brachial neuritis (Parsonage-Turner Syndrome) with hourglass-like constrictions in the affected nerves. J Hand Surg Am. 2011;36(7):1197–203.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Western University, London, ON, Canada

    Kitty Wu

  2. Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Peter Chang & Christopher J. Dy

Authors
  1. Kitty Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christopher J. Dy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher J. Dy .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Alexander Y. Shin

  2. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Nicholas Pulos

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wu, K., Chang, P., Dy, C.J. (2021). Mechanisms of Injury. In: Shin, A.Y., Pulos, N. (eds) Operative Brachial Plexus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-69517-0_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-69517-0_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-69516-3

  • Online ISBN: 978-3-030-69517-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation