Nerve surgery for neonatal brachial plexus palsy

Neonatal brachial plexus palsies may cause lifelong limitations to function of the upper limb. Early nerve reconstructive surgery may be indicated in selected cases. An overview is given of our current understanding of this type of nerve lesion in the developing child. The neuropathology of the injury is presented to provide a background for the understanding of its natural history, as well as for the rationale and methods for nerve surgical treatment. The assessment of upper limb function and the range of severity of the lesions at the very young age are outlined. Decision-making regarding surgical selection and determination of the appropriate procedures is presented, as are the outcomes. Improved function can be obtained with surgical repair.