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The effect of perinatal brachial plexus lesion on upper limb development

Jerzy Gosk1, Witold Wnukiewicz, Maciej Urban

  • 1Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, ul, Borowska 213, 50-556 Wrocław, Poland. chiruraz@umed.wroc.pl.

BMC Musculoskeletal Disorders
|April 4, 2014
PubMed

Insights

Obstetric brachial plexus palsy causes upper limb underdevelopment, particularly in early childhood. Limb size discrepancies correlate with functional deficits and surgical interventions, but not age or surgery timing.

Area of Science:

  • Pediatric Orthopedics
  • Neonatal Neurology
  • Developmental Biology

Background:

  • Obstetric brachial plexus palsy (OBPP) is a common birth injury affecting upper limb development.
  • OBPP results from damage to the brachial plexus nerves during childbirth.
  • This nerve damage can lead to significant functional impairments in the affected limb.

Purpose of the Study:

  • To investigate the impact of brachial plexus birth lesions on upper limb growth and development.
  • To quantify limb length and circumference discrepancies in children with OBPP.
  • To explore correlations between these physical changes and functional outcomes or surgical treatments.

Main Methods:

  • Measurements of limb length and circumference were taken from 44 children with unilateral OBPP.
  • Active motion was evaluated using standardized scales (Gilbert-Raimondi, modified MRC, Al-Qattan).
  • Statistical analyses included paired t-tests and Pearson correlation coefficients.

Main Results:

  • Affected limbs showed decreased circumference and length compared to unaffected limbs.
  • Significant differences in hand dimensions correlated with functional hand use.
  • Forearm and hand measurements varied significantly based on surgical procedures like neurolysis or reconstruction.
  • No correlation was found between limb discrepancies and patient age or time of surgical intervention.

Conclusions:

  • Upper limb underdevelopment in OBPP is most pronounced during early childhood.
  • Limb dimension disparities are evident regardless of the degree of functional impairment.
  • Surgical interventions influence limb measurements, highlighting the importance of timely and appropriate treatment.
Abstract

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