Birth brachial plexus palsy: a race against time

Area of Science:

• Pediatric Orthopedics
• Pediatric Neurosurgery
• Microsurgery

Background:

• Birth brachial plexus palsy (BBPP) is a significant global health burden, particularly in developing nations.
• Delayed diagnosis and limited access to specialized care can worsen outcomes.
• Obstetric trauma is a common cause of BBPP, leading to limb weakness.

Observation:

• A 5-year-old child presented with congenital left upper limb weakness.
• Diagnosis of BBPP was confirmed through clinical examination and history of birth trauma.
• Pre-existing co-contractures severely limited shoulder external rotation and elbow flexion.

Findings:

• Surgical intervention included brachial plexus exploration and microsurgery.
• Procedures involved extrinsic neurolysis of nerve roots and trunks.
• Nerve transfers were performed to enhance shoulder external rotation and elbow flexion.

Implications:

• Effective management of BBPP, even with delayed complications, is crucial.
• Increased awareness and specialized training are needed to improve prognosis.
• Microsurgical techniques offer a viable treatment option for functional recovery in BBPP.