The brachial plexus is not actually one nerve as everyone imagines, but a group of nerves. They are like a grove, rooted in the spinal cord in the cervical and thoracic spinal canal, and then continue to branch out into many branches to control the upper limbs, shoulders and back

Recently, Ms. Guo from Henan posted on the Internet that when she gave birth in the hospital, her baby's brachial plexus was severed by an obstetrician and gynecologist. Netizens were in an uproar.

Today we will do some popular science.

The brachial plexus is actually the general name for a group of nerves

The brachial plexus is not actually a nerve as everyone imagines, but a group of nerves. They are like a plexus, rooted in the spinal cord in the cervical and thoracic spinal canal. Then it continues to branch out into many branches, controlling the sensation and movement of the upper limbs, shoulders, back, and chest.

We can divide the brachial plexus into five parts: roots, trunks, strands, bundles, and branches:

roots: nerve roots There are 5 nerve roots in total, starting from the 4th, 5th, 6th, and 7 cervical vertebra and the 1st and 2nd. The intervertebral foramina between the thoracic vertebrae emits;

trunk: the nerve roots are fused in pairs to form three nerve trunks: the upper, middle and lower nerve trunks . The upper trunk is formed by the fusion of the nerve roots of the 5th and 6th cervical vertebrae, the middle trunk is formed by the fusion of the nerve roots of the 7th cervical vertebra, and the lower trunk is formed by the fusion of the nerve roots of the 8th cervical vertebra and the 1st thoracic vertebra;

strands: 3 nerve trunks And separate the front and back strands respectively. The anterior strands are related to flexion, and the posterior strands are related to extension;

bundles: the 6 strands are merged into lateral bundles, medial bundles, and posterior bundles, a total of 3 bundles. The lateral bundle is formed by the fusion of the anterior strands of the upper trunk and the middle trunk, the medial bundle is formed by the anterior strands of the lower trunk, and the posterior bundle is formed by the fusion of 3 posterior strands;

branches: 3 bundles send out 6 major branches , including the clavicle The lower musculocutaneous nerve (controls elbow flexion), radial nerve (controls extension), ulnar nerve (controls fine movements of the hand), median nerve (controls hand and wrist flexion), axillary nerve (controls external extension) abduction), and the suprascapular nerve above the clavicle (involved in shoulder abduction).

The simplified diagram of the shape is as follows:

For adults, brachial plexus injury is often caused by trauma such as car accidents, iatrogenic injuries caused by surgery , or some neuritis and other medical diseases;

And for newborns In children, brachial plexus injury is often caused by continuous external compression or traction on the baby's head, neck, and shoulders during delivery.

Childbirth brachial plexus injury is a common complication of shoulder dystocia.

Childbirth brachial plexus injury, also known as obstetric paralysis, often occurs after shoulder dystocia during normal delivery .

The so-called shoulder dystocia means that the baby's head comes out, but the shoulder is stuck in the mother's pelvis and cannot come out. At this time, in order to prevent the fetus from suffocating , the doctor sometimes has to pull the head or use forceps or a fetal head suction device to assist the delivery. Under this low-speed, low-energy, and continuous pulling force, the baby may develop head and shoulders. separation, resulting in brachial plexus injury.

In addition, the occurrence of obstetric paralysis is closely related to the basic conditions of the mother and the fetus. For example, the mother has given birth less often, so the pelvic seam is smaller, the mother is older, the delivery is difficult, or the fetus itself is too large, etc., which can easily lead to shoulder dystocia. , resulting in birth paralysis.

After the occurrence of obstetric paralysis, the baby's upper limbs are often limp and like noodles, which will fall off when lifted. The arms are often very soft and have no tension.

According to statistics, about 3‰ of people abroad will suffer from obstetric paralysis. Although specific statistics have not yet been formed in China, even if it is estimated based on the ratio of 3‰, 50,000 to 60,000 people in my country will suffer from this condition every year.

The basic treatment principle for obstetric paralysis is not to perform surgery within 3 months.

Within 3 months after the baby is born, parents do not need to be too anxious.

Generally speaking, it is 5-8 days after the initial onset of It is often possible to immobilize first (just leave it, no need to tie and fix it) to allow the damaged nerves to repair; 8 days later, the child can be helped Rehabilitation exercise , because children are growing every day, long-term disuse of the upper limbs may cause joint atrophy, deformity, and affect development;

Wait until 3 months later, if the child still cannot move his fingers, surgery may be needed ; if 3 After one month, you can continue to recover for 2 months if your hands can move and grasp, but you cannot bend your elbows;

But at the same time, we also need to know that in fact, 70%-80% of children have obstetric paralysis that is not serious, and most do not require surgery. Some children may only have injuries to the upper trunk and upper middle trunk of the brachial plexus, and have difficulty raising the shoulder and flexing the elbow, but their hand function is intact, and 90% of these conditions can usually recover on their own.

Click on the link to learn more about related content→ Childbirth Brachial Plexus Injury (Obstetric Paralysis)-Medical Microvision

Reference: Medical Microvision official website-Chief Physician Wang Shufeng, "Children's Brachial Plexus Injury (Obstetric Paralysis)", "Repair and Reconstruction of Brachial Plexus Injury"