The surgical treatment of traumatic brachial plexus lesions.

The vast majority of severe traumatic lesions of the brachial plexus are due to road accidents. Surgical intervention is indicated in cases of persistent motor and sensory loss. The operation should be performed one to three months after the traumatic event. Indications and results of neurolysis, autologous nerve grafts, and neurotization are reported. Neurolysis was employed 43 times on 36 patients primarily to relieve pain rather than to restore function. Autologous nerve grafting was employed in 100 patients and can give good results when the lesion involves the three upper roots. Neurotization using Bell's nerve was used in 46 patients as a source of axons to re-establish the nervous pathways of the destroyed suprascapular or musculocutaneous nerves.