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Sensory evaluation of the hands in children with brachial plexus birth injury

Tove Palmgren1, Jari Peltonen, Tove Linder

  • 1Department of Hand Surgery, Helsinki University Central Hospital, Helsinki, Finland. tove.palmgren@hus.fi

Developmental Medicine and Child Neurology
|July 20, 2007
PubMed

Insights

Sensory recovery in brachial plexus birth injury (BPBI) hands is generally good, particularly for upper plexus injuries. However, more extensive injuries can lead to impaired fine sensation, and total injuries may not restore protective sensation.

Area of Science:

  • Pediatric Orthopedics
  • Neurology
  • Rehabilitation Medicine

Background:

  • Brachial plexus birth injury (BPBI) can significantly impact hand function and sensation.
  • Understanding sensory changes is crucial for assessing long-term outcomes and guiding treatment.

Purpose of the Study:

  • To investigate the sensory changes in the hands of patients with brachial plexus birth injury (BPBI).
  • To evaluate the impact of injury severity and treatment type on hand sensibility.

Main Methods:

  • Ninety-five patients aged 6-14 years with varying degrees of BPBI (upper, upper-middle, total) were assessed.
  • Sensibility of 32 palmar areas was tested using Semmes-Weinstein monofilaments.
  • Comparison between conservatively and surgically treated patients was performed.

Main Results:

  • Abnormal sensory values were found in 7/64 upper plexus injuries, 5/19 C5-7 injuries, and 4/12 total injuries.
  • Conservatively treated patients demonstrated better hand sensation compared to surgically treated patients.
  • Impairment of fine sensation was noted in more extensive BPBI, with protective sensation not always restored in total injuries.

Conclusions:

  • Hand sensory recovery in BPBI is generally favorable, especially in upper plexus injuries.
  • More extensive BPBI, including total plexus injuries, are associated with a higher likelihood of sensory deficits.
  • Early assessment and appropriate management are vital for optimizing sensory outcomes in BPBI patients.

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