National Hospital of Sri Lanka, Sri Lanka
Title: Revisiting surgical management of closed adult upper and global brachial plexus injury
Biography: Dammika Dissanayake
Brachial plexus injury in adults has variable incidence throughout the world – commoner in those countries where motor cycle use is widespread as a mode of transport. Other types of road accidents, falls from heights, heavy objects falling on shoulder, shoulder dislocation, and entrapment in narrow spaces (machinery) are some of the other universal aetiological factors. Though upper brachial plexus injury is highly treatable surgically there is still scope for improvement in approach as well as technique. On the other hand, surgical management of global brachial plexus injury is still far from being perfect. In fact, variability and unpredictability in surgical results have left many a surgeon think twice before embarking upon certain procedures. Also, I personally feel that surgery at its contemporary standards have not much more to offer. However, there is definitely room for radical thinking that should develop new surgical procedures resulting in excellent outcomes. At the same time, there is a need for radical thinking that should incorporate fast emerging technologies such as robotics, nanotechnology, stem cell research and genetic engineering etc to help regain hand function in global plexus injury patients. In this presentation I have tried to propose a rational approach to decision making and surgical management of both upper and global brachial plexus injuries. This is based on our extensive experience in managing these injuries over the years. It will be presented mainly in the form of algorithms and guidelines.