II. Epidemiology

  1. Uncommon injury
  2. Often requires serious Trauma (Motorcycle accidents)

III. Signs

  1. Arm completely paralyzed and anesthetic
  2. Horner's Syndrome implies poor prognosis

IV. Management

  1. Conservative Management for 3 weeks
    1. Maintain Shoulder and arm range of motion
  2. Myelography and Electromyography evaluation
    1. Normal Electromyogram (EMG)
      1. Consider early surgery
      2. Microscopic neurolysis and nerve repair
    2. Traction Meningoceles or dye pockets
      1. Indicates nerve roots avulsed from cord
      2. Suggests complete, non-reparable and poor prognosis
      3. Consider amputation above elbow 1 year after injury

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