Get Moving Again: Advanced Nerve Injury Care at Barnes-Jewish Hospital

At Barnes-Jewish Hospital, two WashU Medicine physicians, David Brogan, MD, MSc, and Christopher Dy, MD, MPH, are working on new ways to treat brachial plexus damage, a serious nerve injury. These often occur after major accidents, such as car crashes, and can have a big impact on a person’s ability to use their arm and hand.  

The brachial plexus is a group of nerves that control arm movement and feeling in your shoulder, arm, and hand. If these nerves get stretched, torn, or damaged, especially in high-impact trauma, it can lead to pain, weakness, or even complete loss of movement in the arm. Recovery is possible, but it depends on how badly the nerves are affected and how soon treatment begins.  

Why early treatment matters

These injuries are sometimes missed right after an accident. “Seeing patients as early as possible, within a few weeks after their injury, is key to getting better results,” Dr. Brogan says. “Early treatment gives patients the best chance of regaining movement and function in their arm.”

Both Dr. Brogan and Dr. Dy are microsurgical-trained hand surgeons who specialize in hand surgery and peripheral nerve injuries, which are injuries to the nerves outside the brain and spine, often affecting the hands, arms, and legs.  

WashU Medicine orthopedic specialists at Barnes-Jewish Hospital are known for their clinical expertise, and they collaborate with specialists including neurologists, rehabilitation specialists, and mental health providers. The care team is structured to support the patient’s recovery from every angle—physical, functional, and emotional.  

“What makes our program unique is that we focus on both the medical side and personal side of care, treating the whole person and not just the condition,” Dr. Brogan continues.  

Both Dr. Brogan and Dr. Dy are involved in the scientific and clinical aspects of care. Dr. Brogan’s research focuses on the basic science of nerve regeneration, while Dr. Dy focuses on improving patient results, looking at both the physical recovery and the emotional well-being of each person throughout their care journey.  

“As orthopedic surgeons, we’re trained to focus on what we can fix,” Dr. Dy says “But that’s just one part of it. We’re learning to see the whole picture—what this injury does to a person’s identity, to their mental health, and to their family. It can take months to see improvement, and if we catch it late, patients are scared and frustrated. But when we see them early, outcomes are better, and they feel less alone.”

Leading with precision, healing with purpose

Barnes-Jewish Hospital, in partnership with WashU Medicine physicians, brings together a multidisciplinary team of specialists from orthopedics, plastic and reconstructive surgery, and neurosurgery, who collaborate on the treatment and repair of peripheral nerve injuries. Supported by state-of-the-art facilities, and a dynamic research environment, WashU Medicine experts have a long history of developing groundbreaking techniques and treatments for nerve repair.  

Nerve injuries take time to heal, and sometimes they need help. Dr. Brogan and Dr. Dy are studying new ways to boost the body’s natural ability to regrow nerves and restore muscle. Some of this work includes electrical stimulation during surgery to help nerves start healing sooner and a new technique that helps reconnect severed nerve fibers quicker.

These research efforts are leading to real-world treatments, right here in St. Louis.  

Every brachial plexus injury is different, and so is every patient. Dr. Brogan and Dr. Dy personally examine each patient and create a custom treatment plan. During surgery, they explore the injured nerves to see which ones can be fixed, replaced, or re-routed.  

Some of the advanced procedures offered at Barnes-Jewish Hospital include:  

• Free-functioning muscled transfer: Moving a muscle from another part of your body, such as the leg, to your arm to bring back some motion.
• Nerve transfers: Using healthy nerves from other areas of the body to take over the job of the damaged ones.
• Vascularized nerve grafts: Transplanting nerves along with their blood supply to encourage healing.  

These are highly specialized procedures that only a handful of surgeons in the Midwest perform at this level, and they’re seeing hopeful results.  

More than a physical injury

For many patients, a brachial plexus injury isn’t just a physical setback. It’s a life-altering event.  

“Recovery from these injuries isn’t just about nerve repair—it’s about treating the whole person,” Dr. Dy says. “Pain management, psychological support, and guided rehabilitation are essential to maximizing long-term outcomes. This is a devastating injury—something very similar to a spinal cord injury—but isolated to the arm,” Dr. Dy says. “It affects a lot of people in the prime of their lives who are trying to support families. Many of them rely on their hands for their jobs. And when you lose the use of a hand, arm, and shoulder, and the sensation can possibly go with it, your entire life can change.”

According to Dr. Dy, it’s not uncommon for patients to suffer emotionally and financially.  

“We interviewed 20 patients in St. Louis,” Dr. Dy says. “Some patients become homeless because of this. Some lose their jobs. Others go through divorce. It was clear many felt lost in the process. They didn’t know what to expect or when. It was humbling, both as a physician and as a person, to learn what they’ve been through.”  

Because of those interviews, Dr. Dy and Dr. Brogan developed new tools to help patients with their journey. “We worked closely with a medical librarian, a hand therapist, and a pain specialist to develop a brachial plexus patient guide that is used in our office,” Dr. Dy says.  

Recognizing how overwhelming the journey can be, Dr. Dy recently secured a grant from the Foundation for Barnes-Jewish Hospital to add a patient navigator. “Patients need more than surgery,” Dr. Dy says. “They’re asking, ‘Who can help me? How do I get on Medicaid? How do I get to my appointments?’ The navigator helps with all those details.”

The team’s approach is more than surgery—it’s about rebuilding lives. “This is rewarding and life-changing work,” Dr. Dy says. “We’re doing everything we can to help patients regain function, confidence, and hope.”  

To learn more about advanced orthopedic care at Barnes-Jewish Hospital, call 314-996-8970 or visit us online.