Brachial plexus injuries can severely affect arm and hand function, but with timely and expert treatment, patients can reclaim significant mobility and strength. Dr. Jason Ko, a board-certified plastic and reconstructive surgeon serving patients throughout Chicago, specializes in advanced surgical techniques for treating brachial plexus injuries, including nerve grafting, nerve transfers, and tendon transfers. With fellowship training in peripheral nerve surgery and orthopedic hand reconstruction, Dr. Ko provides the precision and experience needed to restore function in both adults and children.
Understanding the Brachial Plexus and Injury Severity
The brachial plexus is a network of nerves that controls movement and sensation in the shoulder, arm, and hand. When these nerves are stretched, compressed, or torn, often due to trauma or birth complications, patients may experience weakness, numbness, or paralysis in the affected limb.
Injuries range in severity from mild (neurapraxia) to complete avulsion, where nerves are torn from the spinal cord. Understanding the nature and extent of the nerve damage is the first step in treatment planning.
Diagnostic Testing and Imaging
Accurate diagnosis is critical. Dr. Ko uses high-resolution MRI and CT imaging to identify nerve damage and pinpoint areas for surgical repair. He also performs nerve conduction studies and electromyography (EMG) to assess how well electrical signals travel through the nerves.
This comprehensive testing helps determine the most effective surgical option, whether that’s nerve grafting, nerve transfer, or a combination of procedures.
Nerve Grafting for Brachial Plexus Injury
Nerve grafting is a foundational treatment used when a segment of the brachial plexus has been damaged or disrupted. In this procedure, a healthy nerve, often taken from the leg (such as the sural nerve in the lower leg), is harvested and used to bridge the gap between the injured ends. Nerve grafting benefits include:
- Reconnects the natural pathway of the injured nerve
- Encourages regeneration along the original anatomical nerve route
- Preserves the complexity of the motor-sensory interface
Because nerve regeneration occurs slowly (approximately 1 mm per day), early intervention is crucial. Grafting is most effective when performed within six months of injury, giving the nerve time to regenerate and reach target muscles before they start to wither.
Nerve Transfer and Tendon Transfer Techniques
When the original nerve pathway is no longer viable or when faster recovery is needed, Dr. Ko may recommend a nerve transfer. This involves taking a nearby functioning nerve and rerouting it to replace the damaged nerve’s function. For example, an intercostal nerve (from the chest) may be redirected to power the biceps.
Tendon transfers offer another option, especially for long-standing injuries or when nerve surgery is not possible. These procedures move a functioning tendon to a new location to restore movement. Tendon transfer benefits include:
- Immediate structural movement
- Useful when muscles have permanently lost innervation
- Helps restore specific functions like wrist extension or finger grasp
In addition, nerve conduction studies and electromyography (EMG) measure nerve function, revealing areas of damage and indicating how well signals are transmitted.
Comparing Nerve Grafting and Nerve Transfer
Nerve grafting and nerve transfer are both highly effective surgical options for treating brachial plexus injuries, but they differ in how and when they’re used.
Nerve grafting is typically the preferred method when there’s a clean break in the nerve and the ends can be bridged. In this approach, Dr. Ko uses a donor nerve, often harvested from the patient’s leg, to reconnect the injured nerve ends. This allows the body’s natural nerve pathways to regenerate along their original route, which is ideal for restoring precise motor and sensory function. However, grafting requires early intervention, usually within six months of the injury, because nerve regeneration is slow and the muscles waiting for input can weaken over time.
In contrast, nerve transfer is often chosen when the original nerve is too damaged or the spinal cord root is avulsed. Rather than trying to repair the injured nerve directly, Dr. Ko reroutes a nearby functioning nerve to take over the lost function. For example, a nerve that powers the chest muscles may be transferred to restore elbow bending. This method can sometimes be used even when treatment is delayed, and it can offer faster or more predictable recovery in certain cases.
In many situations, Dr. Ko combines both approaches. For instance, he may use a nerve graft to restore sensation and a nerve transfer to regain movement. His treatment plans are always tailored to the individual, based on the timing, type, and location of the injury, as well as the patient’s recovery goals.
Pediatric Brachial Plexus Reconstruction
In newborns, brachial plexus injuries are typically caused by trauma during delivery. Although some infants recover on their own, others need surgical intervention. Dr. Ko typically recommends evaluating pediatric patients within the first 6 months of life, with surgery ideally performed before 9 months of age.
Early nerve reconstruction in children improves the chance of full recovery in shoulder, arm, and hand function. Dr. Ko’s experience in pediatric brachial plexus care ensures families receive thorough evaluations, clear guidance, and skilled surgical care.
Recovery, Pain Management, and Prognosis
Recovery varies for each patient. Younger patients with less severe injuries and early intervention tend to see the most significant improvements. While many patients regain near-full function, others may experience residual weakness or sensory deficits.
Pain management is also a key part of care. Dr. Ko offers a multimodal approach that may include oral medications, physical therapy, and nerve blocks.
Rehabilitation plays a vital role in functional recovery. Physical and occupational therapy are customized to support nerve regeneration, retrain muscles, and restore healthy movement.
Why Choose Dr. Ko for Brachial Plexus Treatment
Dr. Jason Ko is a board-certified, fellowship-trained surgeon who is recognized worldwide for his expertise in brachial plexus and peripheral nerve surgery. His unique training combines plastic surgery, orthopedic hand surgery, and microvascular techniques, enabling him to offer a full range of advanced solutions tailored to each patient’s injury and goals.
With an emphasis on both adult and pediatric patients, Dr. Ko is highly skilled at treating patients in all life stages. Whether it’s a birth injury, recent trauma, or a long-standing injury, Dr. Ko offers the precision, compassion, and commitment required to guide your recovery.
Schedule a Consultation with Dr. Jason Ko
If you or your loved one is facing a brachial plexus injury, expert care can make all the difference. Dr. Ko provides leading-edge treatment options backed by extensive training and a deep understanding of nerve reconstruction.
Call our office today at 312-695-6022 to schedule a comprehensive consultation with Dr. Jason Ko in Chicago.