The effect of perinatal brachial plexus lesion on upper limb development

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.