A brachial plexus injury can be repaired—but see an expert and act fast.

Denise McCreery came to in the front seat of her car, which was pressed against a guard rail on I-95 in Maryland.  She was covered in fine bits of blue glass, with the chill March wind blowing easily through the jagged space where her windshield used to be. The engine was still humming, the radio still on.  Noticing that she couldn’t move her left side, she dialed 911 with her right hand.

That was two years ago.  The 31-year-old educator had been struck in the left shoulder by a 13-pound brake drum that had broken off a truck ahead of her.  The hurtling shard had bounced off the asphalt, penetrated deeply into her left shoulder and sliced through the intricate brachial plexus area of her upper torso.  It broke McCreery’s collarbone, two ribs and six vertebrae, paralyzing her left shoulder and arm down to the wrist.  After weeks of physical therapy, a specialist near her home in Virginia imparted the bad news: Injuries to the brachial plexus complex are notoriously unresponsive to even the most skillful medical interventions: “I’m afraid there’s no way you’re going to get your arm back.”

Such predictions are all too common, according to neurosurgeon Allan Belzberg.  What happens then is that patients fail to seek out proper help within an adequate time frame. “Don’t wait,” Belzberg says. “The earlier we get the patients, the better our results.”

Denise McCreery is a case in point.  Just weeks after her accident, McCreery sought a second opinion that brought her to Belzburg.  “Her arm was hanging,” he recalls, “and the hand is almost useless if the arm can’t bend.”  But what McCreery recalls most about that meeting is Belzberg’s description of the wonders of nerve transfer.  “We’ll see what we can do,” he told her.

The operation was scheduled for three months post-accident.  “A good window,” Belzberg says.  When the surgical team opened McCreery’s brachial plexus structure, they had to navigate around formidable stretches of inflexible scar tissue that had rendered some portions of nerve material unusable.  But they also identified working nerve portions they could use for grafts.

For a time, Belzberg explains, the transplanted nerves “remember” their old functions, so McCreery would have to think “make a fist.”  But thanks to their plasticity, transplanted nerves adapt.

Those predictions proved right. Seven months post-op, McCreery could lift her left arm over her head.  Today, she can hold her 23-pound niece aloft “We got in there nicely,” Belzberg says.

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The Departments of Neurology and Neurosurgery at Johns Hopkins Hospital