Brachial plexus injury: Nerve reconstruction and functioning muscle transplantation

David Chwei Chin Chuang

Research output: Contribution to journalJournal Article peer-review

23 Scopus citations


Adult brachial plexus injury remains a dilemma to a reconstructive microsurgeon, especially when attempting to reconstruct cases of total root avulsion. Different degrees and different levels of injury require different strategies of reconstruction. The purpose of this article is to illustrate the author's reconstructive strategy in correlation with the injury level of classification. Nerve transfer, functioning free muscle transplantation, and other palliative surgery are reconstructive options for level 1 injuries. Neurolysis, nerve repair, nerve grafts (free nerve graft or vascularized ulnar nerve graft), nerve transfer if associated with level 1 lesion in other spinal nerves, and palliative reconstruction are chosen options for level 2, 3, and 4 lesions. A clavicle osteotomy is often required in level 3 lesions. Nerve grafts are frequently applied in level 4 lesions, which result in less aberrant reinnervation and a better prognosis.

Original languageEnglish
Pages (from-to)57-66
Number of pages10
JournalSeminars in Plastic Surgery
Issue number1
StatePublished - 2010


  • Brachial plexus injury
  • functioning muscle transfer
  • reconstruction


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