Sandbox: VJP

Overview

Brachial plexus injury (BPI) is an injury to brachial plexus which runs from the spine from fifth cervical vertebra(C5) to underneath the first thoracic vertebra(T1). It innervates and runs through the neck, the axilla and into arm.

BPI can significantly impair the function in one or sometimes both the upper limbs, causing inability to perform daily life activities which can lead to economic crisis, depression and also survival hardships in some cases.

Historical Perspective

Discovery

• The first ever documentation of Obstetric type of BPI was done by Smellie in 1764.
• In 1872, Duchenne found out that traction was the cause of BPI.
• Another Scientist named Erb proposed a theory that the traction or pinching of C5 or C6 roots can also produce BPI.
• Moreover, the first scientist who published an article regarding the direct repair of the components of BPI was Thourborn in 1900.
• In 1903, Harris and Low reported the first neurotizations.
• In 1920, some of the fascicles of the pectoral nerves onto the musculocutaneous and the axillary nerves were re-routed by Vulpius and Stoffel.
• In 1947, Seddon got his method of the surgical correction of traction injuries with application of long interpositional nerve grafts published.
• In 1966, at the Paris meeting of the International Society of Orthopedic Surgery and Traumatology (SICOT), conclusion was made that surgical repair of BPI is almost impossible.
• Later Stevens precisely proposed the bio mechanics of traction in the upper limb and neck and the resultant injuries of the brachial plexus.
• Narakas, Millesi, Allieu, Brunelli, Gu, Terzis, Doi, and others introduced the microsurgical, nerve repair and nerve regeneration techniques successfully.