Musculoskeletal Key

Summary box 1 Brachial plexus injuries are followed by chronic pain in 30–90% of patients. 2 Pain following brachial plexus injuries may be due to neuromas, denervation-reinnervation, avulsion, or musculoskeletal…

Summary box 1 Maintain passive range of motion in all upper extremity joints—especially shoulder external rotation (in both abduction and adduction) and forearm pronation and supination. 2 Force use of…

Summary box 1 Direct inspection alone in the operating room has been shown repeatedly to be unreliable in assessing the severity of peripheral nerve lesions, especially brachial plexus injuries. Therefore,…

Summary Box 1 Early imaging to evaluate injuries associated with neonatal brachial plexus palsies within the first week of life includes radiographs or ultrasonography. 2 At age 3 to 4…

Summary box 1 Brachial plexus and upper extremity musculoskeletal anatomy must be thoroughly understood in order to properly examine, diagnose, and localize brachial plexus injuries. 2 The clinical examination of…

Summary box 1 Comparison of natural history to the outcome of surgical intervention for NBPP is limited by lesion variability, the different assessment paradigms used at different centers, and investigational…

Summary Box 1 The vast majority of persistent brachial plexus lesions in infants is a combination of axonotmesis or neurotmesis in varying proportions. 2 Electrodiagnostic studies are able to determine…

Summary box 1 Establish all the terms and conditions of proposed expert witness work before agreeing to take on the case. 2 An expert witness should be an advocate only…

Summary box 1 Neonatal brachial plexus palsy (NBPP) is identified in the immediate neonatal period and is due to trauma to the fetal brachial plexus at some point prior to…

Summary box 1 The brachial plexus can be organized into 5 zones: spinal nerve roots, trunks, divisions, cords and terminal branches. 2 C5-6 nerve roots form the upper trunk, C7…