Praveen (name changed), a 26-year-old computer engineer, met with a motorcycle accident on a rainy day last year. His world came crashing down when he realized that his right limb was completely paralyzed from shoulder down to the hand.

Doctors in Praveen’s hometown suggested that it might just be a temporary problem and that he would probably recover use of his arm on his own in time to come. Four months later, Praveen had yet to see any improvement. He was anxious to know what was wrong with his hand and what could be done to recover his hand function. He set out to hunt for answers. After physical therapy and a battery of tests, a physician suggested that Praveen should visit The Department of Brachial Plexus & Peripheral Nerve Surgery at Jehangir Hospital for further evaluation and counseling.

A thorough clinical evaluation by the team of Brachial Plexus surgeons at Jehangir Hospital revealed that Praveen had suffered a severe injury resulting in tearing of several nerves (called the Brachial Plexus) in his neck at the time of injury. The torn nerves were unable to provide electrical stimulus to the muscles in his hand and limb, resulting in paralysis of the entire upper limb. Without surgery, he would never be able to use his limb.

The Brachial Plexus team at Jehangir Hospital recommended the surgery be completed soon because the nerves needed time to heal before his hand and arm muscles died completely.

Within a month after his visit to Jehangir Hospital, Praveen underwent surgery. Nerve grafts were used to restore nerve function to his badly damaged brachial plexus nerves. The surgical team harvested a nerve from Praveen’s leg, one that would not cause any additional problems or side effects. The nerve from the leg was then attached to the nerves in Praveen’s neck and shoulder to repair the tear.

“Surgery is a scary option for the patient and his family, said Praveen’s father. But we had to take this decision to give Praveen a chance to use his hand and arm.”

When Praveen began noticing small shoulder and elbow movements in the months after the surgery, it became clear that he had won the first leg of the race. Praveen’s surgery restored nerve activity in his shoulder and elbow, an imperative first step toward recovery.

Praveen had surgery again in a year following his nerve graft surgery. His wrist was fused/blocked to stabilize the floppy wrist. In addition, a tendon from elsewhere in his arm was transferred to the damaged tendons of the hand to restore some finger and hand function.

Today, 2 years after his surgeries, Praveen has started leading a more meaningful life. Because of his surgeries and additional physical therapy, Praveen now has almost full use of this shoulder and elbow and is able to use his injured hand to assist his normal hand in performing most of the activities of daily living.

While talking about this surgery, Head-Dept. Of Hand Surgery, Brachial Plexus & Peripheral Nerve Surgery at Jehangir hospital, Abhijeet Wahegaonkar said, “There are very few people all over the world who do this surgery because these are extremely complex surgeries to do. The biggest problem is timely reference and unfortunately there is a lack of awareness about this injury. These injuries usually occur in young individuals who ride motorcycles and because of road accidents. Most of the time, doctors miss the injury or they tell the patient there is nothing which can be done about this injury. Sometimes doctors who are not aware of the possibilities tell the patients not to worry about the injury, after a certain amount of time the injury will heal; however even after certain amount of time passes the patients injury doesn’t heal.

He further said,” We want to create a general awareness about the possibilities of the treatment. There are multiple procedures that can be done. However, there is a team of doctors of brachial plexus at Jehangir Hospital who work together to give the best outcome to the patients.

Praveen is gainfully employed now in a software company. “I am happy to be able to get back to life and be independent” said Praveen.

What is the Brachial Plexus?
The brachial plexus is a network of nerves that originate near the neck and shoulder. These nerves begin at the spinal cord in the neck and control the hand, wrist, elbow, and shoulder. Nerves are the electrical wiring system in all people that carry messages from the brain to the rest of the body. A nerve is like an electrical cable wrapped in insulation.

What happens when the brachial plexus is injured?
The network of nerves is fragile and can be damaged by pressure, stretching, or cutting. Stretching can occur when the head and neck are forced away from the shoulder, such as might happen in a fall off a motorcycle. Injury to a nerve can stop signals to and from the brain, preventing the muscles of the arm and hand from working properly, and causing loss of feeling in the area supplied by the injured nerve.

About Brachial Plexus and Peripheral Nerve Injury Center, Jehangir Hospital:
The Brachial Plexus and Peripheral Nerve Injury Center at Jehangir Hospital is a leading center for surgery to repair brachial plexus injuries. Brachial plexus surgeons at Jehangir hospital use advanced microsurgical techniques (including nerve and muscle transfers) to repair damaged brachial plexus nerves, muscles and tendons. Patients in Jehangir hospital are assessed and treated by a comprehensive, multidisciplinary team to achieve the most optimum results and outcomes.