Primary Nerve Surgery
If your child requires primary nerve surgery we will aim to do this before they are 6 months of age. They will be given a date for surgery and admitted to the children’s ward. One parent will be allowed to stay overnight with their child whilst they are in hospital.
All surgery is performed under a general anaesthetic and the surgeon will initially examine the nerves to establish the extent of damage. If the nerve is found to be damaged then this part is removed and replaced with a healthy nerve taken from the back of your child’s legs or arm (which is less important) to bridge the gap.
If the nerves have been avulsed (pulled out) from the spinal cord, then nerves from adjacent areas (which do less important jobs) inside and around the plexus will be transferred to aid function to the arm.
After surgery your child’s arm (and legs if grafted) will be bandaged. The arm bandage will also limit any movement of their arm to protect the repair of the nerves. Your child will usually be allowed home after a few days but it is important that the arm bandage stays in place until your next hospital appointment.
You will return to an outpatient dressing appointment 4 to 6 weeks after surgery to remove the bandages and restart exercises. This may be face-to-face in clinic or via a video consultation.
The nerve grafts or nerve transfers will all take many months or even over a year before they start to show signs of recovery.
Secondary Surgery
Sometimes it is necessary to perform surgery when your child is a little bit older. This may include releasing tight muscles (subscapularis release) or to help weaker muscles by means of muscle or tendon transfers. We will discuss with you and your child at each stage the reasons why this maybe considered and the benefits this could offer.