Update on brachial plexus surgery in adults

Purpose of review: Adult traumatic brachial plexus injuries are devastating injuries that in the past have been treated with either amputations and shoulder fusions or benign neglect. The purpose of this current opinion article is to detail the recent advances in the evaluation and management of these patients that have led to improved outcomes. Recent findings: Improved diagnostic modalities along with advances in surgical techniques have allowed reliable restoration of shoulder stability and elbow flexion. Use of novel extraplexal donor nerves in addition to free functioning gracilis muscle transfers now give hope for the restoration of hand function. Summary: An interdisciplinary approach using both extraplexal, intraplexal, and free functioning muscle transfers now allows patients with these devastating injuries to have hope to regain not only shoulder stability and elbow flexion, but potentially hand function.