Management of complete obstetric brachial plexus lesions

From 1978 to 2002, the authors have operated on 723 babies for obstetric brachial plexus repair. Complete paralyses and associated root ruptures and avulsions are severe, and the results cannot be evaluated before the end of growth. A series of 73 patients operated on from 1978 to 1994 were followed with a mean follow-up of 6.4 years. Secondary operations (mainly on the shoulders) were necessary 123 times. Although the results show that the shoulders and elbows did not do as well as in upper-type lesions, the results at the level of the hand were encouraging, showing 75% useful results after 8 years, even in patients with avulsion injuries of the lower roots. These results demonstrate the usefulness of early exploration and repair of the obstetric plexus.