Evaluation and management of brachial plexus birth palsy

Orthop Clin North Am. 2014 Apr;45(2):225-32. doi: 10.1016/j.ocl.2013.12.004. Epub 2014 Jan 29.

Abstract

Brachial plexus birth palsy can result in permanent lifelong deficits and unfortunately continues to be relatively common despite advancements in obstetric care. The diagnosis can be made shortly after birth by physical examination, noting a lack of movement in the affected upper extremity. Treatment begins with passive range-of-motion exercises to maintain flexibility and tactile stimulation to provide sensory reeducation. Primary surgery consists of microsurgical nerve surgery, whereas secondary surgery consists of alternative microsurgical procedures, tendon transfers, or osteotomies, all of which improve outcomes in the short term. However, the long-term outcomes of current treatment recommendations remain unknown.

Keywords: Brachial plexus; Brachial plexus birth palsy; Nerve injury; Obstetric brachial plexus palsy; Shoulder dystocia.

Publication types

  • Review

MeSH terms

  • Birth Injuries / diagnosis*
  • Birth Injuries / etiology
  • Birth Injuries / surgery*
  • Brachial Plexus Neuropathies / diagnosis*
  • Brachial Plexus Neuropathies / etiology
  • Brachial Plexus Neuropathies / surgery*
  • Humans
  • Humerus / surgery
  • Osteotomy
  • Range of Motion, Articular
  • Shoulder Joint*
  • Tendon Transfer