Abstract
Traumatic brachial plexus injuries in children, excluding birth palsy, are seldom reported. In this study, we report on 11 cases operated upon between 1995β1998, and followed for at least 30 months. All patients were males with an average age of 11 years (range, 3β16 years). The denervation time averaged 3.8 months (range, 1β8 months). Eight patients had two or more root avulsions; two had additional severe infraclavicular injuries. In total, 6 grafting and 25 extraplexal neurotization procedures were used. Donor nerves included the intercostal nerves, phrenic nerve, spinal accessory nerve, and contralateral C7 root. Elbow flexion was restored in all but 2 cases. Shoulder abduction varied from 30β90Β°, according to the method of reconstruction. Triceps recovered in 2 cases and finger and wrist extensors in 1 case. Wrist and finger flexion was obtained in 1 case. Sensory recovery in the palm reached S2/S2+. Harvesting the phrenic nerve and the contralateral C7 root resulted in no residual morbidity. Compared to adults, children have a higher incidence of root avulsion, no deafferentiation pain, a higher incidence of associated skeletal injuries, and the same recovery rate of elbow and shoulder functions following plexus reconstruction, but recovery is faster. Given the frequency of root avulsions, neurotization is often required. Β© 2003 WileyβLiss, Inc. MICROSURGERY 23:14β17 2003