Radiation Plexopathy

Radiation induced brachial plexopathy represents a constellation of symptoms that present in a delayed manner because of peri-plexus progressive fibrosis or direct neural injury with demyelination. Symptom onset is typically delayed months to years after radiotherapy. Patients may report neuropathic pain, weakness, or extremity dysfunction associated with morbidity and diminished quality of life. Reported surgical interventions include plexus neurolysis, nerve transfers, and vascularized free tissue transfer. In this review, we aim to present the practicing hand surgeon with an update and analysis on the current state of the radiation induced brachial plexopathy literature.