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Methods for In Vivo Biomechanical Testing on Brachial Plexus in Neonatal Piglets
Published on: December 19, 2019
Intermediate Type of Obstetric Brachial Plexus Palsy
1Department of Obstetrics, King Saud University, Riyadh, Saudi Arabia amelelsayed62@hotmail.com.
Insights
Three rare cases of obstetric brachial plexus palsy were identified, presenting as mild intermediate types predominantly affecting the C7 root. These infants showed excellent spontaneous motor recovery within 6-12 months.
Area of Science:
- Neurology
- Pediatrics
- Orthopedics
Background:
- Obstetric brachial plexus palsy (OBPP) is a significant birth injury.
- Classic OBPP types include Erb's, extended Erb's, and total palsies.
- Understanding rare OBPP variations is crucial for accurate diagnosis and management.
Observation:
- A review of 829 infants with OBPP identified three cases (0.4%) not fitting classic classifications.
- These unusual cases presented with bilateral or unilateral palsy, characterized by "abducted arms" and "flexed forearms."
- Electrophysiological findings indicated denervation of shoulder adductors and triceps.
Findings:
- The three atypical cases were classified as mild "intermediate" types of OBPP.
- The C7 root was identified as the predominant site of injury in these cases.
- All affected infants demonstrated excellent spontaneous motor recovery within 6 to 12 months.
Implications:
- Recognition of these intermediate OBPP types can refine diagnostic approaches.
- Identifying C7 root involvement aids in predicting prognosis.
- The findings suggest that prompt identification and management of these milder forms lead to favorable outcomes.
Abstract:
Data of 829 infants with obstetric brachial plexus palsy were reviewed to identify any cases that could not be fitted into the any of the well-known types of palsy. These unusual cases were studied in detail with regard to clinical presentation and electrophysiological findings as well as management and spontaneous motor recovery. Erb's, extended Erb's, and total palsies were seen in 42.8%, 28.8%, and 28.0% of cases, respectively. Three cases (0.4%) did not fit into any of the classic types. One case had bilateral palsy, and the remaining 2 cases had unilateral palsy. All affected limbs presented with "abducted arms," "flexed forearms," and electrophysiological evidence of denervation of shoulder adductors and triceps. All cases had excellent spontaneous recovery within 6-12 months. It was concluded that these cases represent mild "intermediate" types of palsy in which the C7 root was the predominant site of injury. Good spontaneous recovery is expected.
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