Brachial Plexus: Part I—Anatomy, Clinical Syndromes, and Trauma

fascinated with the way its nerves display a complex anatomic matrix of anastomoses (Figure 1). Those are further hidden between the upper chest, neck, and shoulder, making their surgical exposure difficult. William Smellie is credited with the first description of brachial plexus palsy in the 18th century, which he noticed in a newborn. There is evidence however of a much earlier clinical diagnosis in the Syriac Book of Medicines from the 12th century. Traumatic brachial plexus injury was studied by Flaubert, Duplay, and Reclus in the 1800s. Erb and Klumpke described upper and lower injuries, respectively, and idiopathic brachial plexopathy was defined by Parsonage and Turner in 1948. Thorburn performed the first brachial plexus anastomosis in the 20th century. Nerve transfers were reported in the late 19th century (facial nerve, radial to median nerve), but successful brachial plexus transfers with good long-term follow-up functions were not reported until the mid-20th century, with the efforts of Lurje, Seddon, Kotani, and many others.