Introduction

First described in 18th century by the English Pathologist SMELLIE, the lesion was related to its clinical picture by the French surgeon, DANYAU, at the beginning of the 19th Century.
In 1867, the French neurologist, DUCHENNE DE BOULOGNE, related the lesion directly to obstetrical trauma and gave it its name of “paralysie obstétricale”.
Many surgeons have been interested in the lesion since then but a remarkable work was done by two New York neurosurgeons, TAYLOR and KENNEDY, who in 1902 published their first results after surgical repair of the plexus. Unfortunately, however, surgical repair of the plexus also came with a high rate of anesthetic complications.

From 1970, NARAKAS from Switzerland and MILLESI from Austria revived the surgical repair of the plexus by treating adults who had traumatic injuries. In 1977 surgeons GILBERT in Paris and MORELLI, RAIMONDI and PETROLATI in Italy established the protocol and treatment that is still currently in use.

Since then, several teams in Switzerland, Holland, England, Germany, Spain, Sweden, Finland, Japan and North America have developed expertise in treating these patients.
The opinions given on this site are based on the experience of over 1.800 obstetrical brachial plexus "primary surgeries" and 2.200 "secondary surgeries" that have been followed for over the past more than 35 years by the Paris and Milan teams. Some of the issues are still controversial but are continuously being discussed by the major international teams in gatherings in different meetings .
From these meetings and from papers published in recognized journals, our indications and techniques have become more and more refined. The existence of support groups has been of great interest to the surgical teams. They have enabled the surgeons to encompass wider aspects of the problem.
An international data bank has been formed and information from cases around the world is being collected. Treatment is also being promoted in developing countries. It is now more than 50 years that the surgery of Brachial Plexus is a reality.
Unfortunately , if the repair of upper lesions ( C5-C6 or C5-C6-C7 ) gives reasonably good results , the complete lesions of the plexus still represent an unsolved problem.

Two surgeons with a wide experience : Pr. A. Gilbert and Dr P. Raimondi have joined their experience to give their thoughts on this difficult subject . They have together operated more than 3.000 patients with brachial plexus lesions, over more than 30 years and have experienced all the techniques available . This site is a summary of this experience .



Who is who?

Pr A. Gilbert

Ancien Interne et Chef de clinique de la Faculté de Médecine de Paris
Professeur Associé à la Faculté de Médecine Saint Antoine
Ancien Président de la Société Française de Chirurgie de la Main
Ancien Président de la Fédération Européenne des Sociétés de Chirurgie de la Main.

Dr P. Raimondi

Consultant Hand surgeon Cinica Mater Domini
Istituto Clinico Humanitas – Castellanza (VA) Italy
Member of the Italian Society for Surgery of the Hand
Member of the French Society for Surgery of the Hand
Honorary Member of the Spanis Society for Surgery of the Hand
Honorary Member of the Spanish Society of Microsurgery