"So there are three basic types of injuries, depending on the severity and direction of trauma. The upper plexus injury, wherein the shoulder and biceps are paralyzed, the lower plexus injury, which causes the hand to be paralyzed while sparing the upper arm, or the complete brachial plexus injury, where the entire shoulder, arm and hand are left useless. There are several different patterns of brachial plexus injury. Probably the most common that we see is the upper plexus injury. And this refers to an injury that predominates in the upper trunk of the brachial plexus, which refers to the combination of a C5 and C6 nerve roots. An injury to this portion of the brachial plexus results in paralysis of the shoulder and of the biceps, but usually leaves the patient with a functional hand. Patient unfortunately is unable to position that hand in space, and this renders the arm useless. A patient can also suffer a lower brachial plexus injury. This usually occurs when the arm is pulled up, forcefully over the head and results in a preferential injury to the C8 and T1 nerve roots or the lower trunk of the brachial plexus. This has an opposite presentation where the patient has dysfunction or complete paralysis of the hand, while their shoulder and upper arm work to position the hand in space. A patient can also suffer a complete brachial plexus injury, where all five roots of the brachial plexus are completely lost and the patient has no ability to move the arm or hand at all. The patient is left with a flaccid insensate arm that has no ability to be used at all."
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