[Nerve grafting and other plastic procedures in traumatic injuries of the brachial plexus (author's transl)].

In 52 patients with traumatic injuries of the brachial plexus plastic procedures were carried out on the nerves in order to improve function: primary suture of the torn portion of the plexus (one case), external and internal neurolysis with division of the epineurium (four times), anastomosis of the secondary branches or the main arm nerves, with the intercostal nerves by insertion of sural transplants (47 times). Seventy per cent showed an improvement in protective sensation and in 48% a useful gain in motor function was achieved. The results are dependent on the age of the patient (better results in the younger patients), on the interval between injury and operation (failure when the injury was more than one year previously), and the anatomical site (good regeneration with axillary and musculo-cutaneous, partial success with the radial and median, and failure with ulnar nerves). Although complete recovery cannot be expected, we recommend that such a "plastic" nerve operation should be done before considering the radical step of a definitive arthrodesis or amputation.