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Obstetrical brachial plexus injuries: incidence, natural course and shoulder contracture
1Department of Rehabilitation Medicine, Academic Medical Center, Amsterdam, The Netherlands. a.f.hoeksma@worldonline.nl
Insights
Obstetric brachial plexus injury (OBPI) affects 4.6 per 1000 newborns. While most recover, delayed recovery and shoulder contracture are common, even with complete neurological healing.
Area of Science:
- Pediatrics
- Neurology
- Obstetrics
Background:
- Obstetric brachial plexus injury (OBPI) is a significant concern in childbirth.
- Understanding its incidence and natural progression is crucial for patient outcomes.
Purpose of the Study:
- To investigate the incidence of OBPI.
- To describe the natural course of OBPI, including recovery times.
- To determine the frequency of shoulder contracture in relation to recovery.
Main Methods:
- A retrospective study of 13,366 births between 1988 and 1997.
- Identified 62 cases of OBPI.
- Analyzed recovery patterns and the development of shoulder contracture.
Main Results:
- The incidence of OBPI was 4.6 per 1000 births.
- Complete neurological recovery occurred in 72.6% of cases, with a mean recovery time of 6.2 months.
- Shoulder contracture was observed in at least one-third of infants with delayed recovery and two-thirds with incomplete recovery.
Conclusions:
- The incidence and natural course of OBPI in this cohort were less favorable than typically reported.
- Shoulder contracture is a frequent complication, even in infants achieving complete neurological recovery.
Abstract:
The incidence of obstetric brachial plexus injury (OBPI) was investigated and the natural course of this disorder and the frequency of shoulder contracture described. Between 1988 and 1997 13,366 children with a gestational age of 30 weeks or more, were born at the Academic Medical Center, Amsterdam. Of these, 62 had an OBPI (4.6 per 1000). Complete neurological recovery occurred in 72.6% of cases. Half of them had a delayed recovery of more than three weeks (mean recovery time 6.2 +/- 3.1 months). Shoulder contracture occurred in at least one-third of the children with delayed recovery and in at least two-thirds of the children with incomplete recovery. The incidence of OBPI in our hospital was found to be higher and to have a less favourable natural course than is usually reported in the literature. Contracture of the shoulder joint is frequently found even in infants with complete neurological recovery.