Explore This Program

Our Mission

The mission of the Mass General Brigham Brachial Plexus & Nerve Disorders Program is to provide innovative, multidisciplinary clinical care for patients with disorders of the brachial plexus nerves and any other peripheral nerves of the hand and arm. We take an integrated approach to care that incorporates the input and expertise of orthopaedic surgeons, nerve surgeons, neurologists, physiatrists, pain specialists, physical therapists, and occupational therapists. By collaborating across teams and hospitals, the program is able to offer our patients the most advanced clinical care.

About Our Program

The Mass General Brigham Brachial Plexus & Nerve Disorders Program treats patients with the entire spectrum of peripheral nerve disorders of the hand and arm, from brachial plexus injuries to digital neuromas. The goal of the program is to provide the best evidence-based clinical outcomes for patients through surgical and non-operative means. We offer Harvard-trained expertise and decades of combined experience to offer minimally invasive treatments that include nerve transfers, tendon transfers, joint/bony stabilization and re-alignments, free tissue transfers and other reconstructive solutions.

What is the Brachial Plexus?

The brachial plexus is the network of nerves connecting the spinal cord to the shoulder, arm and hand. Congenital or traumatic injuries to this network can result in pain, numbness, loss or impairment of local function, posture and mobility.

What Injuries and Conditions Affect the Brachial Plexus?

We treat both traumatic and non-traumatic nerve disorders of the shoulder, arm and hand, including:

  • Brachial plexus injuries (any injury resulting in inability to move arm)
  • Cerebral palsy
  • Difficulty moving the shoulder and elbow from birth (congenital)
  • Loss of feeling and function in arm after prior surgery/treatment
  • Nerve compression (compressive neuropathies)
  • Previously diagnosed brachial plexus nerve disorders with persistent pain, loss of feeling, and loss of function
  • Stroke
  • Spastic arm
  • Thoracic outlet syndrome

What Treatments are Available for Brachial Plexus Conditions?

A variety of treatment options are available for brachial plexus conditions, including both nonoperative and surgical treatments. In the Mass General Brigham Brachial Plexus & Nerve Disorders Program, patients can expect a team of physicians with expertise in nerve disorders to perform a detailed physical examination. Further studies may be ordered, including x-rays, MRIs, and nerve tests. Some brachial plexus conditions improve without surgery, and in these cases, many patients benefit from physical therapy and/or occupational therapy to rehabilitate recovering nerves and muscles. More severe brachial plexus conditions may benefit from surgery. A variety of surgical options are available, depending on the severity and duration of symptoms alongside other patient factors. Our team of experts work in collaboration with the patient to develop a custom treatment plan that reflects each individual patient’s values and preferences.

Surgical treatment options for brachial plexus injury include:

Brachial plexus neurolysis: Brachial plexus neurolysis is a surgery to explore the nerves of the brachial plexus, rid them from any external compression, and free them from surrounding scar tissue.

Joint fusion: Joint fusion surgery treats arthritic, unstable or flail joints by fusing two bones into one.

Muscle or tendon transfer: Tendon transfer surgery connects a healthy, expendable muscle or tendon to a nonfunctional muscle or tendon.

Nerve grafting: Nerve grafting surgery replaces an injured nerve with a healthy one, implanted from another part of the body through microsurgery.

Nerve transfer: Nerve transfer surgery connects a healthy, expendable donor nerve to an injured nerve through microsurgery.

For Referring Providers

The Mass General Brigham Brachial Plexus Program welcomes referrals from doctors nationally and internationally. To refer a patient, send us an email or simply fill out an online referral form. For international patients, the International Patient Center at Massachusetts General Hospital is a full-service office that assists overseas patients seeking a consultation, a second opinion or medical treatment.

Brachial Plexus Research

Recent publications:
  • Zhang D, Garg R, Elhassan B, Winograd J. Factors Associated with 30-Day Adverse Events After Brachial Plexus Neurolysis. J Hand Surg Global Online Vol. 4, Issue 6:332-336. 2022. Read the summary on Advances in Motion
  • Zhang D, Dyer GSM, Garg R. Delayed Referral for Adult Traumatic Brachial Plexus Injuries. J Hand Surg Am. 2021;46(10):929.e1-929.e7.
  • Zhang D, Garg R, Earp BE, Blazar P, Dyer GSM. Shoulder Arthrodesis versus Upper Trapezius Transfer for Traumatic Brachial Plexus Injury: A Proportional Meta-Analysis. Adv Orthop. 2021;2021:4445498.
  • Venkatramani H, Bhardwaj P, Raja Sabapathy S, Bandari G, Zhang D, Dheenadhayalan J. Floating Shoulder Injury Resulting in Delayed Onset of Infraclavicular Brachial Plexus Palsy. J Hand Surg Asian Pac Vol. 2020;25(4):499-503.
  • Zhang D, Varadharajan V, Bhardwaj P, Venkatramani H, Sabapathy SR. Considerations in the Selection of Donor Nerves for Nerve Transfer for Reanimation of Elbow and Shoulder in Traumatic Brachial Plexus Injuries. J Hand Surg Asian Pac Vol. 2022;27(1):10-21.
  • Zhang D, Elhassan B, Garg G. Patient Characteristics Associated with Operative Treatment for Adult Traumatic Brachial Plexus Injuries at Two Tertiary Referral Hospitals in a Single U.S. Metropolitan Area. J Hand Surg Asian Pac Vol. 2022. In press.
  • Zhang D, Garg R, Elhassan B, Winograd J. Factors Associated with 30-Day Adverse Events Following Brachial Plexus Neurolysis. J Hand Surg Glob Online. 2022. In press.
  • Lädermann A, Bothorel H, Collin P, Elhassan B, Favard L, Bernal N, Raiss P, Athwal GS. Could Subtle Obstetrical Brachial Plexus Palsy Be Related to Unilateral B Glenoid Osteoarthritis? J Clin Med. 2021;10(6):1196.
  • Werthel JD, Wagner ER, Elhassan BT. Long-term results of latissimus dorsi transfer for internal rotation contracture of the shoulder in patients with obstetric brachial plexus injury. JSES Open Access. 2018;2(3):159-164.
  • Wagner ER, Werthel JD, Ansari M, Shaughnessy W, Elhassan BL. Natural History of the Elbow Bony Architecture in Patients With Obstetric Brachial Plexus Injury and the Association With Flexion Contractures. J Am Acad Orthop Surg. 2018;26(23):e490-e495.
  • Werthel JD, Schoch B, Frankle M, Cofield R, Elhassan BT. Shoulder Arthroplasty for Sequelae of Obstetrical Brachial Plexus Injury. J Hand Surg Am. 2018;43(9):871.e1-871.e7.
  • Elhassan BT, Wagner ER, Spinner RJ, Bishop AT, Shin AY. Contralateral Trapezius Transfer to Restore Shoulder External Rotation Following Adult Brachial Plexus Injury. J Hand Surg Am. 2016;41(4):e45-51.
  • He J, Elhassan B, Garg R. Brachial Plexus Exam, In "Clinical Examination of the Hand" 2022 Garg R, Elhassan T. Management of Shoulder in Brachial Plexus injuries- American Academy of Orthopaedic Surgeons (AAOS) Resident Curriculum, 2022.

Meet our Team

Mass General Brigham brachial plexus surgeons work hand-in-hand with colleagues in neurology, pain management, occupational & physical therapy, and physical medicine & rehabilitation to deliver comprehensive, all-inclusive care to every patient we serve.


Team Members