​What kinds of symptoms do patients experience before receiving treatment?

Symptoms of brachial plexus injury (BPI) vary on the severity and location of the injury, but include muscle weakness, loss of sensation, pain, and paralysis. BPI can cause neuropathic pain with damage to the spinal cord and can be long-lasting, with effects such as burning numbness.

​What is the impact on patients’ lives of living with these conditions?

The impact of a brachial plexus injury can range in severity; some patients may experience weakness or great pain, others may be paralyzed in their shoulder and upper arm. This can make day-to-day tasks difficult and impair quality of life.

What cultural or regional factors affect the treatment of these conditions?

Motorcycle collisions are the most common cause of brachial plexus injury, and are, unfortunately, an exceedingly common occurrence in Cambodia.

What does the treatment process look like?

Treatment for brachial plexus injury can involve nerve repair, nerve grafting, nerve transfer, or tendon and muscle transfers depending on the location and type of injury, and the amount of time since the injury occurred. A nerve repair involves reattaching a severed nerve; nerve graft is a procedure that takes a healthy nerve from another part of the body and transplants it to the injured nerve to guide regrowth; a nerve transfer is a procedure that cuts a donor nerve and connects it to the injured nerve when there is no functioning nerve stump to attach a graft. Nerve regeneration occurs approximately at a rate of 1 mm/day, and so recovery from a brachial plexus injury can take months for small improvements. Physical therapy during this time is important to prevent stiffness, contractures, or atrophy and increase the chances of regaining good movement in the affected limb.

What is the impact of this treatment on the patient’s life?

While BPI surgery may not restore full movement to a patient, it can greatly increase the patient’s ability to use the affected limb and reduce the pain of the injury.

What potential side effects or risks come with this treatment?

BPI surgery is complicated and risks include infection as well as failure to restore movement, which would require further surgery.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Surgery to treat brachial plexus injury can be very complex and not widely performed. Surgical treatment in Cambodia can be expensive and hard to access. Patients will travel for hours by car, motocycle, and bus to receive free surgery at CSC.

What are the alternatives to this treatment?

Brachial plexus injury can have a range of severity; some patients may be able to be treated by splinting or physical therapy, but serious cases require surgical intervention. These types of injuries do not have alternatives to improving movement and functionality.