Persistent brachial plexus birth palsies

Sixty-six brachial plexus palsies in 64 patients were retrospectively reviewed at the San Francisco Unit of the Shriners Hospital system in a 15-year period from 1973 to 1988. All patients were referred with persistent brachial plexus palsies caused by birth trauma. The distribution of palsies at birth included 34 upper palsies, three lower palsies, and 29 mixed (or global) palsies. At final follow-up, the distribution of palsies had shifted and included 42 upper palsies, 6 lower palsies, and 14 mixed (or global) palsies. One patient had a persistent flail upper extremity. Many previously documented obstetrical risk factors were confirmed. Time to resolution or plateau averaged 4.5 months (range 3 weeks to 18 months). Only two palsies (one patient) resolved completely with time.