The natural history and management of brachial plexus birth palsy

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 lim...

Full description

Saved in:
Bibliographic Details
Published in:Current reviews in musculoskeletal medicine 2016-12, Vol.9 (4), p.418-426
Main Authors: Buterbaugh, Kristin L., Shah, Apurva S.
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Orthopedics
Pediatric Orthopedics (B Heyworth
Pediatric Orthopedics (B Heyworth, Section Editor)
Rehabilitation Medicine
Section Editor
Sports Medicine
Surgery
Surgical Orthopedics
Topical Collection on Pediatric Orthopedics
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1935-973X
1935-9748
DOI:10.1007/s12178-016-9374-3