As a life care planner, upper extremity injuries are something I see fairly frequently. They can be long-lasting and detrimental to a patient’s personal and work life. And the restriction or loss of the use of an arm, as you can imagine, can have significant repercussions for a person of any age.
What is an Upper Extremity Nerve and Traction Injury?
These injuries are often caused by motor vehicle accidents. They can also occur due to recreational (sports) and occupational activities.
A situation occurs where the arm is pinned, causing traction to the brachial plexus. This is the network of nerves which runs through the cervical spine, the neck, through the axilla and into the arm. A traction injury elongates that bundle of nerves between the neck and the shoulder.
The brachial plexus is a constellation; any injury to these nerves affects both sensory and motor function. In some of the worst-case scenarios, the victim suffers a loss of the upper extremity. They can also be left with a flail arm, or a non-usable appendage.
There are both immediate and long-term implications for an injury of this type. We’ll talk about some of those below, and the work that I did recently with two patients who presented with upper extremity nerve and traction injuries.
Treating These Injuries from a Life Care Planning Perspective
As a doctor of physiatry and a life care planner, my concerns for the patient cover two things. I’m going to look closely both at their immediate care and comfort requirements, and the long-term treatment they will require to maintain the lifestyle to which they are accustomed.
There can be severe repercussions when an injury of this type is not treated in a comprehensive manner.
“If the patients are treated with a delay, or if the care is inappropriate, it will often reduce the functional outcome and create further costs for society due to potentially more extensive surgical procedures, longer rehabilitation and longer sick leave.” — NCBI
The Implications of Upper Extremity Nerve and Traction Injuries
In other words, we want to help people immediately. This was the case with two people I worked with recently; both were younger and had been involved in car accidents. The first patient was walking when he was hit; the second was on a bike.
Some of the first steps included pain relief, procuring the appropriate brace and/or splint, and addressing the limitations of going from the full use of two hands to the use of one. We then addressed our next concerns, which included swelling, edema, and a lack of circulation. Secondary infection is a risk with these types of injuries, as are additional injuries. It is easier to hurt yourself if you cannot feel that part of your body.
Any life care plan for a person with an upper extremity injury involving nerve damage is going to include all of these things. Ongoing physical therapy is a must; even if the patient has plateaued after some time. This is far more beneficial physically than risking inactivity or inattention to the area . . . which can lead to a far graver situation years down the line.
Finally, a care plan needs to address the loss of household services, trouble with daily tasks, and work restrictions. The input of a life care planner in these situations can set the patient up with proper care and rehabilitation well into the future. There is no dollar amount for how valuable this service can be in these cases.
If someone you know is dealing with this type of nerve injury, I strongly recommend contacting my office. Send us an email, and my team will get back to you quickly.