Dual mechanism responsible for brachial plexus injuries

Brown, Beth A.; Karmin, Ira; Łapiński, Radosław; Lescale, Keith B.

doi:10.1016/s0002-9378(97)80535-2

Cited by 6 publications

(4 citation statements)

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“…It appears that PBPP in the absence of shoulder dystocia occurs by a different mechanism (25,26) and is a distinct entity. In infants with PBPP, but without shoulder dystocia, birth weight is smaller and the rate of persistence at one year of age is significantly higher (ie, 41.2% versus 8.7%) and affects the posterior shoulder more commonly, suggesting an in utero mechanism, possibly from pressure of the shoulder against the bony maternal pelvis (27).…”

Section: Risk Factorsmentioning

confidence: 98%

Perinatal brachial plexus palsy

Andersen

Watt

Olson

et al. 2006

Paediatrics &Amp; Child Health

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It is not possible to predict which infants are at risk for PBPP, and therefore amenable to preventive measures. Twenty-five per cent of affected infants will experience permanent impairment and injury. If recovery is incomplete by the end of the first month, referral to a multidisciplinary team is necessary. Further research into prediction, prevention and best mode of treatment needs to be done.

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Section: Risk Factorsmentioning

confidence: 98%

Perinatal brachial plexus palsy

Andersen

Watt

Olson

et al. 2006

Paediatrics &Amp; Child Health

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“…These findings further called into question the belief that clinician‐applied forces were the cause of the injury. The first of these articles was by Jennett et al in 1992 (4), and their article was followed by ten others (5,10–18) between 1993 and 1997. These studies revealed that about one‐half of Erb's palsies occur without concurrent shoulder dystocia.…”

Section: Increased Frequency With An Ultrashort Second Stagementioning

confidence: 99%

Erb's Palsy Causation: A Historical Perspective

Sandmire

DeMott

2002

Birth

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A better understanding of the forces involved when brachial plexus injury occurs has evolved over the past 10 to 15 years. A particular challenge was that all of the useful information had to be derived indirectly by identifying associations-a challenge that was met by individual researchers who made significant observations that, in turn, stimulated others to search for additional findings. Gradually the pieces of the puzzle began to form the picture. The significant steps in this journey were first, the recognition of the substantial number of injuries occurring without concurrent shoulder dystocia; second, the finding that a much greater frequency of injury is associated with an ultrashort second stage of labor; third, the observations that the injury rate is independent of the experience of the birth attendant; fourth, the recognition of the substantial numbers of injuries occurring in the posterior arm; and fifth, the anecdotal experience of countless delivery attendants, who relate that the forces applied in the injured cases were perceived to be no stronger than those applied when no injury occurred. We present a historical review for each step in this journey. We reviewed all articles published on this subject in Obstetrics and Gynecology and the American Journal of Obstetrics and Gynecology and some European journals. The period for review primarily covered articles published since 1980. Several textbooks on obstetrics and child neurology were also reviewed.

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“…The indirect evidence from the 22 references cited in our article, however, provide strong causative evidence. We cannot accept Allen and Edelberg's viewpoint that all those physicians from all those university centers (5, 7–18, Table 1) negligently applied excessive lateral traction, and that traction caused the brachial plexus injuries.…”

mentioning

confidence: 95%