The natural history of recovery of elbow flexion after obstetric brachial plexus injury managed without nerve repair

2017 ◽  
Vol 42 (7) ◽  
pp. 706-709 ◽  
Author(s):  
T. E. J. Hems ◽  
T. Savaridas ◽  
D. A. Sherlock
Keyword(s):  
Brachial Plexus ◽  
Spontaneous Recovery ◽  
Brachial Plexus Injury ◽  
Elbow Flexion ◽  
Nerve Reconstruction ◽  
Level Of Evidence ◽  
Severe Injuries ◽  
Obstetric Brachial Plexus ◽  
The Mean ◽  
Obstetric Brachial Plexus Injury

In this study, we report the outcome for spontaneous recovery of elbow flexion in obstetric brachial plexus injury managed without nerve reconstruction. Excluding those with transient paralysis, our records revealed 152 children with obstetric brachial plexus injury born before our unit routinely offered brachial plexus reconstruction. Five had had nerve repairs. Of the remainder, only one patient had insufficient flexion to reach their mouth. Elbow flexion started to recover clinically at a mean age of 4 months for Narakas Group 1, 6 months for Group 2, 8 months for Group 3 and 12 months for Group 4. The mean active range of elbow flexion, in 44 cases, was 138°. The mean isometric elbow flexion strength, in 39 patients, was 63% (range 23%–100%) of the normal side. It appears to be rare for elbow flexion not to recover spontaneously, although recovery occurs later in more severe injuries. It is doubtful if nerve reconstruction can improve elbow flexion above the likely spontaneous recovery in babies with obstetric brachial plexus injuries. Level of evidence: II

scholarly journals Evidence that nerve surgery improves functional outcome for obstetric brachial plexus injury

2020 ◽  
pp. 175319342093467
Author(s):  
Willem Pondaag ◽  
Martijn J. A. Malessy
Keyword(s):  
Surgical Treatment ◽  
Brachial Plexus ◽  
Spontaneous Recovery ◽  
Brachial Plexus Injury ◽  
Nerve Repair ◽  
Functional Evaluation ◽  
Nerve Reconstruction ◽  
Obstetric Brachial Plexus ◽  
Nerve Surgery ◽  
Obstetric Brachial Plexus Injury

The majority of children with obstetric brachial plexus injury show some degree of spontaneous recovery. This review explores the available evidence for the use surgical brachial plexus repair to improve outcome. So far, no randomized trial has been performed to evaluate the usefulness of nerve repair. The evidence level of studies comparing surgical treatment with non-surgical treatment is Level IV at best. The studies on natural history that are used for comparison with surgical series are also, unfortunately, of too low quality. Among experts, however, the general agreement is that nerve reconstruction is indicated when spontaneous recovery is absent or severely delayed at specific time points. A major obstacle in comparing or pooling obstetric brachial plexus injury patient series, either surgical or non-surgical, is the use of many different outcome measures. A requirement for multicentre studies is consensus on how to assess and report outcome, both concerning motor performance and functional evaluation.

Comparing the Efficacy of Triple Nerve Transfers with Nerve Graft Reconstruction in Upper Trunk Obstetric Brachial Plexus Injury

2017 ◽  
Vol 140 (4) ◽  
pp. 747-756 ◽  
Author(s):  
Kathleen M. O’Grady ◽  
Hollie A. Power ◽  
Jaret L. Olson ◽  
Michael J. Morhart ◽  
A. Robertson Harrop ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Nerve Graft ◽  
Nerve Transfers ◽  
Obstetric Brachial Plexus ◽  
Graft Reconstruction ◽  
Obstetric Brachial Plexus Injury

The Effects of Virtual Reality on Upper Extremity in Patients with Obstetric Brachial Plexus Injury

2021 ◽  
Author(s):  
Havva Ezgi Karas ◽  
Emine Atıcı ◽  
Gamze Aydın ◽  
Mert Demirsöz
Keyword(s):  
Virtual Reality ◽  
Brachial Plexus ◽  
Upper Extremity ◽  
Brachial Plexus Injury ◽  
Control Group ◽  
Nintendo Wii ◽  
Significant Difference ◽  
Obstetric Brachial Plexus ◽  
Conventional Physiotherapy ◽  
Obstetric Brachial Plexus Injury

AbstractThe present study aimed to examine the effects of playing Nintendo Wii games on upper extremity functions compared with conventional physiotherapy, in children with obstetric brachial plexus injury (OBPI). Twenty-two patients with brachial plexus injuries were enrolled. The patients were divided into two groups by simple randomization. The control group (conventional physiotherapy group [CTG]: n = 11) received conventional physiotherapy for 6 weeks (40 minutes per day, for 4 days per week). The study group, called Nintendo Wii group (NWG; n = 11), received conventional physiotherapy as well as tennis, baseball, and boxing games with Nintendo Wii on days when there was no physical therapy. The upper extremity range of motion (ROM) was evaluated using a digital goniometer, motor function was assessed using the Active Movement Scale (AMS), and shoulder functions were assessed with the Mallet Scoring System (MSS). Virtual reality treatment had a positive effect on shoulder flexion, forearm pronation, wrist flexion, ROM, and functionality (p < 0.05). There was a significant improvement in shoulder abduction and shoulder external rotation in the CTG (p < 0.05). There was no significant difference in the MSS values of either groups (p > 0.05). As per the AMS, in the NWG, the shoulder internal rotation increased significantly (p < 0.05). Nintendo Wii treatment used in addition to conventional physiotherapy may be effective in increasing upper extremity functions in children with OBPI. Clinical Trials Number NCT04605601.

scholarly journals Bilateral obstetric brachial plexus injury: A case report

2013 ◽  
Vol 88 (3) ◽  
pp. 267-272
Author(s):  
Kamila Okulczyk ◽  
Bożena Okurowska-Zawada ◽  
Janusz Wojtkowski ◽  
Anna Kalinowska ◽  
Anna Mirska ◽  
...  
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Obstetric Brachial Plexus ◽  
Obstetric Brachial Plexus Injury
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