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Published on: March 27, 2026
Obstetric brachial plexus injury
Mukund R Thatte1, Rujuta Mehta
1Department of Plastic Surgery, Bombay Hospital Institute of Medical Sciences, New Marine Lines, Mumbai, India.
Insights
Obstetric brachial plexus injury (OBPI) affects newborns, with many requiring surgical intervention for optimal recovery. Early evaluation by a specialized hand surgeon is crucial for favorable outcomes in affected children.
Area of Science:
- Pediatric Surgery
- Neurology
- Orthopedics
Background:
- Obstetric brachial plexus injury (OBPI), or birth brachial plexus injury (BBPI), is a common newborn condition.
- While some infants experience spontaneous recovery, a significant number require surgical treatment.
Purpose of the Study:
- To review the causes, surgical indications, and outcomes of OBPI.
- To emphasize the importance of early intervention and specialized care for affected infants.
Main Methods:
- Comprehensive review of peer-reviewed publications on OBPI.
- Inclusion of extensive clinical experience from the authors over 15 years.
Main Results:
- Detailed discussion of OBPI causes and surgical indications for primary nerve surgery and secondary reconstruction.
- Positive outcomes reported for nerve surgery, with significant benefits for children undergoing intervention.
Conclusions:
- Early surgical intervention and specialized care by hand surgeons can lead to good results in OBPI cases.
- Secondary surgeries are effective for addressing shoulder, elbow, and hand issues in children with OBPI.
Abstract:
Obstetric brachial plexus injury (OBPI), also known as birth brachial plexus injury (BBPI), is unfortunately a rather common injury in newborn children. Incidence varies between 0.15 and 3 per 1000 live births in various series and countries. Although spontaneous recovery is known, there is a large subset which does not recover and needs primary or secondary surgical intervention. An extensive review of peer-reviewed publications has been done in this study, including clinical papers, review articles and systematic review of the subject. In addition, the authors' experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Causes of OBPI, indications of primary nerve surgery and secondary reconstruction of shoulder, etc. are discussed in detail. Although all affected children do not require surgery in infancy, a substantial proportion of them, however, require it and are better off for it. Secondary surgery is needed for shoulder elbow and hand problems. Results of nerve surgery are very encouraging. Children with OBPI should be seen early by a hand surgeon dealing with brachial plexus injuries. Good results are possible with early and appropriate intervention even in severe cases.
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