Background:There are three primary surgical solutions: neurolysis, neurotization (nerve transfer) and nerve grafting. These may be performed alone or in combination with each other. The choice of which peripheral nerve surgery technique is appropriate is based on which method will maximize and encourage the natural regenerative process of the nerve. We use nerve transfer and grafting, depending on the intra-operative findings and with our surgical experiences. Injuries of C5-C6 do not always warrant surgery if injury to C7 is minor. In patients where C8 and T1 are involved in addition to C5-C7, hand function is also affected, therefore nerve repair for the upper and middle trunks is more likely to be required.Early surgical interventions have been shown to improve the limb functions in this group of patients. Management of secondary deformities in OBPI has typically been through the performance of various operative procedures including tendon transfers, muscle releases, axillary nerve decompression, humeral osteotomy, biceps tendon lengthening, glenohumeral capsulorrhaphy and anterior capsule release