Abstract
Obstetrical brachial plexus palsy displays a stable incidence of approximately 1 per 1,000 live births. Most children show good spontaneous recovery, but in 20% to 30% an important residual motor impairment remains.
Between 2000 and 2016, total of 185 patients with obstetrical brachial plexus injury were examined in Department of Neurosurgery, 3rd Faculty of Medicine, Charles University, Prague, and 48 underwent nerve surgery. The aim of our study was to evaluate the results achieved using various surgical techniques in patients with partial and total obstetrical brachial plexus palsy.
The overall success rate in upper plexus birth injury was 80% in shoulder abduction, 50% in external rotation and 81.8% in elbow flexion with median follow-ups of 36 months. Success rate in complete paralysis was 87% in finger and thumb flexion, 87% in shoulder abduction, and elbow flexion in 75%, the median follow up was 46 months.
Useful reanimation of the hand was obtained in patients who underwent end-to-side neurotization. Conclusion: Improved function can be obtained in infants with obstetrical brachial plexus injury with early surgical reconstruction.