**Introduction**

nerve root avulsions, particularly when all or almost all the brachial plexus nerve roots are avulsed. Some attempts to reimplant avulsed roots have been tried, but clinical results in

This book offers a new look at the field of brachial plexus injuries, taking advantage of the vast experience and knowledge of great figures who treated these dreadful conditions over many years. We hope the reader enjoys the book as much as the authors did writing it.

> **Vicente Vanaclocha** Assistant Professor

**Nieves Sáiz-Sapena** University of Valencia Valencia, Spain

Valencia, Spain

Department of Neurosurgery Hospital General Universitario

humans have been dismal.

VIII Preface

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Brachial Plexus Injuries - Past,**

Although they have a low incidence [1–3], brachial plexus injuries continue to be a cause of serious disability [4]. Their victims are mostly young people in the middle of their lives or newborns, always with worrisome long-term consequences [2–4]. Unfortunately brachial plexus lesions can also be the result of iatrogenic injuries [5]. The quality of life of those

Nowadays, road accidents in young people continue to be the most common cause, particularly when the victim is thrown in the air and lands on the shoulder [2, 5, 10]. This is particularly common in developing Third World countries, where people have to recourse to the motorcycle for their daily transportation [1, 11–14], as a car is an option outside their reach. Other causes are wars [15–17] and assaults [18, 19]. The incidence is higher in males than in females [1, 2, 13, 20], probably related to the highest aggressiveness and violent behavior in the former [21]. In newborns brachial plexus injuries are usually due to problems during vaginal delivery [3, 22], particularly in case of a macrosomic fetus [23, 24], common in diabetic mothers [25]. In the developed countries, the fear of unpleasant medicolegal consequences in case of an obstetric brachial plexus injury has induced a significant increase in the proportion of cesarean section deliveries [26, 27]. The incidence of iatrogenic brachial plexus lesions unfortunately continues to be stable overtime with no signs of reduction [5, 28–30]. These iatrogenic lesions are induced while performing lymph node biopsy [5, 31, 32], vessel catheterization [33, 34], on applying radiotherapy in the treatment of cancer [35, 36] repairing upper limb bone fractures [37, 38], in programmed orthopedic procedures [39, 40], due to inadequate patient positioning [41, 42] or when restraining aggressive patients [43]. Preventing these iatrogenic injuries is particularly important, not only because they might lead to ugly medicolegal consequences [28] but because of our motto "primum non nocere"

affected is devastated, with high personal [4, 6], familial [7], and societal costs [8, 9].

**Introductory Chapter: Brachial Plexus Injuries - Past,** 

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.81675

**Present, and Future**

**Present, and Future**

Vicente Vanaclocha and Nieves Saiz-Sapena

Additional information is available at the end of the chapter

Vicente Vanaclocha and Nieves Saiz-Sapena

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.81675

**1. Introduction**

### **Introductory Chapter: Brachial Plexus Injuries - Past, Present, and Future Introductory Chapter: Brachial Plexus Injuries - Past, Present, and Future**

DOI: 10.5772/intechopen.81675

Vicente Vanaclocha and Nieves Saiz-Sapena Vicente Vanaclocha and Nieves Saiz-Sapena Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.81675
