Functional outcomes of infants with Narakas grade 1 birth-related brachial plexus palsy undergoing neurotization compared with infants who did not require surgery

Zuckerman, Scott L.; Allen, Laura A.; Broome, C; Bradley, Nadine; Law, Charlie; Shannon, Chevis N.

doi:10.1007/s00381-016-3039-9

Cited by 2 publications

(1 citation statement)

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“…One group underwent nerve transfers, while the other progressed past the point of needing intervention. Both demonstrated similar long-term function at 2 years [79]. Despite this challenge, microsurgical procedures have demonstrated reliable return of shoulder function in 60-80 % of cases and return of elbow flexion against gravity in 80-100 % of cases [11,14,42,80,81].…”

Section: Discussionmentioning

confidence: 91%

The natural history and management of brachial plexus birth palsy

Buterbaugh

Shah

2016

Curr Rev Musculoskelet Med

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Brachial plexus birth palsy (BPBP) is an upper extremity paralysis that occurs due to traction injury of the brachial plexus during childbirth. Approximately 20 % of children with brachial plexus birth palsy will have residual neurologic deficits. These permanent and significant impacts on upper limb function continue to spur interest in optimizing the management of a problem with a highly variable natural history. BPBP is generally diagnosed on clinical examination and does not typically require cross-sectional imaging. Physical examination is also the best modality to determine candidates for microsurgical reconstruction of the brachial plexus. The key finding on physical examination that determines need for microsurgery is recovery of antigravity elbow flexion by 3-6 months of age. When indicated, both microsurgery and secondary shoulder and elbow procedures are effective and can substantially improve functional outcomes. These procedures include nerve transfers and nerve grafting in infants and secondary procedures in children, such as botulinum toxin injection, shoulder tendon transfers, and humeral derotational osteotomy.

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