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Prognosis and early management of birth injuries to the brachial plexus

G C Bennet, A J Harrold

    British Medical Journal
    |June 19, 1976
    PubMed

    Insights

    Most infants with birth-related brachial plexus injuries recover function with exercises. Suprascapular nerve paralysis persisted in non-recovered cases, with reconstructive surgery for severe, permanent injuries.

    Area of Science:

    • Pediatrics
    • Neurology
    • Orthopedics

    Background:

    • Birth injuries to the brachial plexus (BP) are a recognized complication of childbirth.
    • Obstetric complications, such as shoulder dystocia requiring traction, are frequently associated with BP injuries.

    Purpose of the Study:

    • To review outcomes of brachial plexus birth injuries (BPBI) over a 15-year period.
    • To identify predictive factors for recovery and long-term functional deficits.

    Main Methods:

    • Retrospective review of 24 cases of BPBI in 21 infants over 15 years.
    • Assessment of functional recovery, need for interventions (splints, surgery), and nerve involvement.

    Main Results:

    • Full recovery occurred in 75% of affected arms following physiotherapy exercises.
    • No splints were required; reconstructive surgery was performed on 3 infants with permanent paralysis around age 4.
    • Suprascapular nerve paralysis was universal and persisted in arms with incomplete recovery.
    • No reliable predictors for recovery were identified.

    Conclusions:

    • Early physiotherapy is effective for most brachial plexus birth injuries.
    • Persistent suprascapular nerve involvement indicates a poorer prognosis.
    • Surgical intervention may be considered for severe, permanent cases.

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