## Overview Brachial plexus avulsion or neuropathy is traumatic injury to the network of nerves that supply the forelimb. The plexus can be compressed between the scapula and ribs or stretched by extreme limb abduction. The result is partial or complete loss of motor and sensory function to the limb, often producing a non-weight-bearing leg with a dropped elbow and muscle atrophy. ## Causes Falls, collisions, or being cast with a limb trapped are typical. Traction during anesthetic recovery or hobble use has also been implicated. Fractures of the first rib can damage the plexus secondarily. ## Diagnosis Clinical signs of radial, suprascapular, or more extensive nerve deficits (inability to extend the elbow, shoulder instability, knuckling) after trauma are characteristic. Electrodiagnostics and advanced imaging can confirm the extent of injury; radiographs rule out fractures. ## Treatment Anti-inflammatory medication, physical therapy, neuromuscular electrical stimulation, and protective bandaging or splinting to prevent contracture are the mainstays. Surgical exploration is rarely beneficial. Many cases are managed supportively while waiting to see how much function returns. ## Recovery and Prognosis Prognosis is guarded. Some horses regain useful limb function over weeks to months; others remain non-weight-bearing and require euthanasia. Early, intensive rehabilitation improves the chance of a functional outcome. ## Prevention Careful handling during anesthesia and avoidance of situations that trap a forelimb reduce risk.
non-weight-bearing forelimb; dropped elbow; shoulder instability or lateral rotation; muscle atrophy of the shoulder and arm; knuckling of the fetlock
## Overview Brachial plexus avulsion or neuropathy is traumatic injury to the network of nerves that supply the forelimb. The plexus can be compressed between the scapula and ribs or stretched by extreme limb abduction. The result is partial or complete loss of motor and sensory function to the limb, often producing a non-weight-bearing leg with a dropped elbow and muscle atrophy. ## Causes Falls, collisions, or being cast with a limb trapped are typical. Traction during anesthetic recovery or hobble use has also been implicated. Fractures of the first rib can damage the plexus secondarily. ## Diagnosis Clinical signs of radial, suprascapular, or more extensive nerve deficits (inability to extend the elbow, shoulder instability, knuckling) after trauma are characteristic. Electrodiagnostics and advanced imaging can confirm the extent of injury; radiographs rule out fractures. ## Treatment Anti-inflammatory medication, physical therapy, neuromuscular electrical stimulation, and protective bandaging or splinting to prevent contracture are the mainstays. Surgical exploration is rarely beneficial. Many cases are managed supportively while waiting to see how much function returns. ## Recovery and Prognosis Prognosis is guarded. Some horses regain useful limb function over weeks to months; others remain non-weight-bearing and require euthanasia. Early, intensive rehabilitation improves the chance of a functional outcome. ## Prevention Careful handling during anesthesia and avoidance of situations that trap a forelimb reduce risk.
non-weight-bearing forelimb; dropped elbow; shoulder instability or lateral rotation; muscle atrophy of the shoulder and arm; knuckling of the fetlock