Persistent Brachial Plexus Birth Palsies

Ah, Jahnke; Df, Bovill; Hr, McCarroll; James, P; Rk, Ashley

doi:10.1097/01241398-199107000-00022

Cited by 33 publications

(14 citation statements)

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“…51 Thirty-four publications did not meet any of the present inclusion criteria. 11,43,44,46,49,[51][52][53][54][55]57,58,60,62,63,[65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83] Of the remaining 42 articles, 35 met one criterion, and seven articles met two criteria (Tables III and IV). As none of the articles met three or four criteria, the protocol was changed in that a second reviewer evaluated the papers meeting two inclusion criteria.…”

Section: Results Of Searchmentioning

confidence: 99%

“…The validity of this somewhat arbitrary limit is borne out by reports describing a steady functional state after two to three years. 4,10,74,90 Only two authors reported ongoing recovery after this period, in sporadic cases. 102,107 Additionally, neurological examinations become more accurate as children get older because of their increased ability to cooperate.…”

Section: Follow-upmentioning

confidence: 99%

See 1 more Smart Citation

Natural history of obstetric brachial plexus palsy: a systematic review

Pondaag

Malessy

Dijk³

et al. 2004

Develop Med Child Neuro

314

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Section: Results Of Searchmentioning

confidence: 99%

Section: Follow-upmentioning

confidence: 99%

Natural history of obstetric brachial plexus palsy: a systematic review

Pondaag

Malessy

Dijk³

et al. 2004

Develop Med Child Neuro

314

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“…Strength testing in our patient population at 3 months of age appears to be more prognostic in children who will go on to complete recov ery without intervention; whereas, strength testing at 6 months of age more accurately identifies those patients who will have unacceptable (less than antigravity strength) outcomes without surgical intervention. Also, early surgical correction is advocated to avoid permanent changes in the denervated muscle and developing skeletal system that result in long-term orthopedic sequelae [59,60], For those infants who are appropriate surgical candi dates, surgery offers an excellent chance for long-term functional recovery. Many studies have shown that neuro logic improvement occurs in 75-95% of patients undergo ing surgical reconstruction of the brachial plexus [4, 20, 25-28, 30, 31, 39.…”

Section: Indications and Results O F Surgerymentioning

confidence: 99%

Outcome of Surgically Treated Birth-Related Brachial Plexus Injuries in Twenty Cases

Sherburn¹,

Kaplan²,

Kaufman³

et al. 1997

Pediatr Neurosurg

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Birth-related brachial plexus injury occurs in 0.19–2.5 per 1,000 live births, of which 70–92% improve with conservative management. With the advent of microsurgical techniques, patients who fail expectant treatment may benefit from brachial plexus exploration and reconstruction. From 1991 to 1996, 87 patients were referred to the multidisciplinary brachial plexus clinic at St. Louis Children’s Hospital. Twenty patients were selected for surgical management. The average age at surgery was 10.5 months (range 3–35, median = 8), with an average follow-up of 23.9 months (range 7–45, median = 24). Two patients were lost to follow-up. Surgical procedures included neurolysis (n = 8), neurotization (n = 2), nerve grafting (n = 5), and a combination (n = 3) of the above. Two patients underwent exploration without repair. Intercostal nerves, pectoral nerves, and C4 roots were used for neurotizations, and the sural nerve was used for nerve grafting. Results from 18 patients were available for follow-up review. Fifteen patients (83% demonstrated clinical improvement postoperatively. Of the 3 patients without improvement, 2 underwent exploration without repair, and one underwent neurolysis of the axillary nerve. Of patients undergoing reconstruction, 93% had improved strength postoperatively. No subjects had worsening neurologic status, and there were no complications. These results suggest that surgery for birth-related brachial plexus injury may show favorable outcomes if patients are selected appropriately. Patients undergoing neurolysis and nerve grafting had more favorable outcomes than those undergoing neurotization.

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“…The incidence of BP birth injuries varies from 1 to 2 per 1000 live births (35). According to the components of the BP that are injured, obstetrical BP paralysis may be classified as follows: 1) ErbDuchenne upper-arm paralysis, in which the C5 and C6 nerves or their derivatives are principally involved; 2) Klumpke's lower-arm paralysis, in which the C8 and T1 nerves are affected; or 3) paralysis of the entire arm, in which there is some involvement of all components of the BP (19,23,35). When the entire arm is paralyzed, the upper limb is almost completely flaccid and there is often extensive sensory loss (6,26,35).…”

mentioning

confidence: 99%