Permanent brachial plexus birth palsy does not impair the development and function of the spine and lower limbs

Area of Science:

• Orthopedics
• Neurology
• Pediatric Surgery

Background:

• Permanent brachial plexus birth palsy (BPBP) impacts upper limb function.
• The effect of BPBP on the developing motor system and locomotion is not well understood.
• Avulsion injuries in BPBP can potentially affect the cervical spinal cord.

Purpose of the Study:

• To investigate the long-term effects of brachial plexus surgery for BPBP on motor function and locomotion.
• To assess the impact of BPBP on the development of the overall motor system.
• To evaluate the functional outcomes and participation in physical activities in patients with a history of BPBP.

Main Methods:

• A cohort of 111 patients who underwent brachial plexus surgery for BPBP in infancy were evaluated.
• Mean follow-up duration was 13 years (range: 5-32 years).
• Physical activity participation and functional limitations were assessed using questionnaires.

Main Results:

• No significant differences in leg length or incidence of structural scoliosis were observed compared to the general population.
• 43% of patients exhibited asynchronous upper limb motion during gait, linked to impaired upper limb function.
• Despite challenges like muscle weakness and joint stiffness (reported by 71%), most patients could engage in activities like cycling, skiing, and swimming.

Conclusions:

• BPBP and its surgical treatment do not appear to significantly affect overall skeletal development (leg length, scoliosis).
• Asynchronous upper limb movement during gait is common in individuals with a history of BPBP, reflecting persistent functional deficits.
• While functional limitations exist, most individuals with BPBP can achieve a good level of participation in daily physical activities.