[Palsy of the upper limb: Obstetrical brachial plexus palsy, arthrogryposis, cerebral palsy]
B Salazard1, C Philandrianos2, B Tekpa3
1Service de chirurgie plastique Enfants, hôpital Saint-Joseph, 26, boulevard de Louvain, 13008 Marseille, France.
Insights
Pediatric upper limb palsy, including cerebral palsy and brachial plexus palsy, requires early, intensive rehabilitation. Management involves clinical exams, functional assessments, and tailored treatments like splinting, physiotherapy, and surgery to address stiffness and deformities.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Pediatric upper limb palsy encompasses conditions like cerebral palsy, arthrogryposis, and obstetrical brachial plexus palsy.
- These conditions, regardless of brain involvement, result in early functional limitations such as hypomobility, stiffness, and deformities.
Purpose of the Study:
- To outline the comprehensive management strategies for pediatric upper limb palsies.
- To emphasize the critical role of early and intensive rehabilitation in improving outcomes.
Main Methods:
- Thorough clinical examination of the affected limb.
- Assessment of the child's daily living needs and environmental factors.
- Multidisciplinary approach integrating physiotherapy, splinting, and surgical interventions.
Main Results:
- Early and intensive rehabilitation initiated at birth is crucial.
- A combination of conservative and surgical treatments addresses specific impairments.
- Management requires a holistic approach considering the child's overall needs and environment.
Conclusions:
- Effective management of pediatric upper limb palsy necessitates a comprehensive, multidisciplinary approach.
- Early intervention and tailored rehabilitation programs are key to mitigating long-term consequences.
- Surgical interventions are employed to correct joint stiffness, bone deformities, muscle contractures, and spasticity.
Abstract:
"Palsy of the upper limb" in children includes various diseases which leads to hypomobility of the member: cerebral palsy, arthrogryposis and obstetrical brachial plexus palsy. These pathologies which differ on brain damage or not, have the same consequences due to the early achievement: negligence, stiffness and deformities. Regular entire clinical examination of the member, an assessment of needs in daily life, knowledge of the social and family environment, are key points for management. In these pathologies, the rehabilitation is an emergency, which began at birth and intensively. Splints and physiotherapy are part of the treatment. Surgery may have a functional goal, hygienic or aesthetic in different situations. The main goals of surgery are to treat: joints stiffness, bones deformities, muscles contractures and spasticity, paresis, ligamentous laxity.
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