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brachial plexus

Posts Tagged ‘brachial plexus’

Brachial Plexus Injuries

The Brachial Plexus is an extremely complex network of nerves that starts from the spinal cord at the level of the neck and gives innervation to the entire upper extremity, both for motion and sensation.

Trauma Related Paralysis

Paralysis of the brachial plexus in adults occurs mainly secondary to high velocity trauma. The most common cause is motor-vehicle accidents (cars, motorcycles, snowmobiles, etc.). Often, the patient may suffer other injuries that may be life threatening and need to be treated in an emergency basis i.e. vessel injuries, bone injuries, head injuries, abdominal and chest injuries.

Even if the brachial plexus injury is not life threatening, it can result in complete or partial paralysis of the entire upper arm and loss of sensation. This is obviously a devastating injury for the function of the patient. The patient with a diagnosed brachial plexus injury must be evaluated as soon as possible, because the shorter the time period between the traumatic event and the time treatment starts, the better the chance for the patient to regain function in his arm.Therefore the referral to the brachial plexus specialist should be done sooner, rather than later.

The reconstruction of the torn nerve elements in a patient with brachial plexus paralysis is usually staged. If the injury is very severe, at least two operations are required to reconnect the injured nerves. Often secondary operations are needed to transfer muscles from the legs to the affected arm in order to restore a missing function. The patient usually stays in the hospital for two or three days after the surgery and then is discharged. Postoperatively, the arm is immobilized in a brace. Following removal of the brace, in six to eight weeks, physical therapy commences. Usually, the operations are spaced so we can see what function has been regained in the arm and then formulate a plan for the next step of reconstruction.


Dr. Julia K. Terzis is an internationally known Plastic and Reconstructive Surgeon in the field of peripheral nerve injuries, facial reanimation and facial rejuvenation, and functional restoration after brachial plexus injuries.

Dr. Terzis obtained her Medical Degree from Thomas Jefferson University in Philadelphia, Pennsylvania and her Ph.D. in Neurophysiology of sensory skin receptors from McGill University, Montreal, Canada.

She has been the Director of the Microsurgical Program at Eastern Virginia Medical School and a Professor in the Department of Surgery, Division of Plastic Surgery, Eastern Virginia Medical School. In September 2011 she moved to NYC where she is Adjunct Professor in the Department of Plastic and Reconstructive Surgery, NY University Medical Center.

She is the recipient of multiple awards and honors including: The James Barrett Brown Award for the most significant contribution in the field of Plastic and Reconstructive Surgery which she received in 1976 for her work in reinnervation of skin grafts, and again in 2000 for her contributions in the treatment of Brachial Plexus Injuries; The Gold Medal in Surgery from the Royal College of Physicians and Surgeons of Canada in 1981; The Academy Achievement Award in the field of Natural Sciences from AHEPA Foundation in 1987; The Emanuel B. Kaplan Award for the best anatomical paper from the American Society for Surgery of the Hand; Woman of the Year “Salute to Women Award” in 1998 by the Daughters of Penelope organization for her contributions in paralysis restoration. In 2008, she received the Clincian of the year award, American Association of Plastic Surgeons. In 2009 she received the Distinguished Fellowship Award from the American Association of Plastic Surgeons
In 2010 she was the recipient of the PSEF Outstanding Achievement in Basic and Translational Research Award.
She was the recipient of the 2010, Best Paper Award in the Clinical Category by the American Society of Maxilofacial Surgery. Finally, also in 2010, The American Society of Plastic Surgeons honored her by extending Honorary Membership in ASPS- currently only six plastic surgeons hold this honorary membership worldwide.

Dr. Terzis is the author of six textbooks, numerous manuscripts and peer reviewed articles in the field of reconstructive microsurgery. In addition, she has been an invited Professor to over 300 different academic centers around the world over the past thirty years.

Dr. Terzis is a founding member of the International Society for Reconstructive Microsurgery. She is also the past Chairman of the Plastic Surgery Research Council, past President of the American Society of Reconstructive Microsurgery, and a past President of the International Microsurgical Society. She is the founding President of the American Society of Peripheral Nerve and, Past President of the World Society for Reconstructive Surgery, and immediate Past president of the European Association of Plastic Surgeons.