Pediatric Brachial Plexus Treatment
The Brachial Plexus Clinic at Rady Children’s Hospital-San Diego provides specialized, multidisciplinary care for infants, children, and adolescents with brachial plexus injuries. Our team offers comprehensive evaluations, individualized treatment plans, and ongoing follow-up care to support each child’s recovery and maximize their function.
About Brachial Plexus Injuries
The brachial plexus is a network of nerves that controls movement and sensation in the shoulder, arm, and hand. Injuries to this nerve system can result from birth complications or traumatic accidents, affecting a child’s ability to move or feel in their upper limbs.
What is the Brachial Plexus?
The brachial plexus consists of five nerve roots (C5-T1) that extend from the spinal cord. These nerves are responsible for:
- C5 and C6: Shoulder movement and elbow bending
- C7: Wrist movement and elbow straightening
- C8 and T1: Hand and finger movements
Damage to these nerves can range from mild stretching to complete separation from the spinal cord (avulsion).
Causes of Brachial Plexus Injuries
Common causes include:
- Traumatic accidents, like falls or sports injuries
- Prolonged or complicated labor
- Large birth weight
Symptoms of Brachial Plexus Injuries
Symptoms vary depending on the severity of the injury and may include:
- Weakness or paralysis in the arm or hand
- Reduced movement or sensation
- An arm that hangs limply or cannot move
- Drooping eyelids or difficulty breathing in severe cases
Treatment Options at Rady Children’s Hospital
Our expert team provides personalized care for children with brachial plexus injuries. Treatment options include:
Non-Surgical Treatments
- Occupational Therapy: Focuses on improving range of motion, muscle strength, and joint flexibility.
- Home Exercise Programs: Families receive guidance to support recovery at home.
- Therapeutic Taping and Splinting: Encourages proper positioning of the arm and hand.
- Botox Therapy: Temporarily weakens overactive muscles to restore balance and allow weaker muscles to strengthen.
Surgical Treatments
- Microsurgical Nerve Repair: Recommended if there is no shoulder or elbow function by six months of age.
- Nerve Transfers: Redirects healthy nerves to restore function in damaged areas. Recommended between 6-9 months of age.
- Tendon and Muscle Transfers: Improves mobility by repositioning tendons or muscles. Usually done later in childhood as needed.
- Osteotomies: Adjusts bone positioning to enhance function. Typically performed later in childhood as needed.
- Free Muscle Transfers: Involves transplanting muscles to replace damaged ones in severe cases.
Our Multidisciplinary Team
Our multidisciplinary team brings together experts from various specialties such as Rehabilitation Medicine, Orthopedics, and Occupational Therapy to provide the most effective care for children with brachial plexus injuries. These professionals have extensive experience managing complex nerve injuries and have treated hundreds of children with brachial plexus palsy.
Our Team Includes:
- Pediatric Upper Extremity Surgeon: Specializing in surgical interventions such as nerve repair, transfers, and reconstructive procedures.
- Occupational & Hand Therapists: Helping children regain strength, mobility, and functional independence through personalized therapy.
- Rehabilitation Medicine Physician: Overseeing non-surgical care, coordinating treatment plans, and supporting long-term recovery.
- Physician Assistant: Assisting in clinical evaluations, treatment coordination, and follow-up care.
- Care Coordinator: Ensuring seamless communication between families and specialists to provide comprehensive support.
Meet Our Experts:
- Michael Kwon, M.D., Associate Clinical Professor of Orthopedic Surgery, UC San Diego
- Kate Hinchcliff, M.D., Associate Clinical Professor, Hand and Upper Extremity Surgeon, UC San Diego
- Susan Biffl, M.D., Associate Clinical Professor of Orthopedic Surgery, UC San Diego
- Amanda Asaro, P.A.-C – Physician Assistant
- Denise Hoover, OTR/L, CHT – Occupational/Hand Therapist
- JD McCrossin, R.N. – Care Coordinator
Why Early Intervention Matters
Timely evaluation and treatment are crucial. Untreated nerve damage beyond 18 months may result in permanent muscle weakness. Early care supports optimal recovery and developmental outcomes.
Partnering with Families
At Rady Children’s Hospital, we empower families through education and resources, ensuring they feel confident in supporting their child’s recovery. From advanced therapies to compassionate care, we are committed to helping children regain function and thrive.
Contact Us
If your child has experienced a brachial plexus injury, early evaluation is key to their recovery. Consultations with our multidisciplinary team, including pediatric upper extremity surgeons are available.
Rehabilitation / Physical Medicine – Contact: 858-966-8974
Orthopedic Injury Clinic – Contact: 858-966-6789