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Updated: Nov 2, 2025

Methods for In Vivo Biomechanical Testing on Brachial Plexus in Neonatal Piglets
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Brachial Plexus Birth Injuries: A Critical Analysis Review

Nicholas Pulos1, William J Shaughnessy1, Robert J Spinner1,2

  • 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

JBJS Reviews
|June 8, 2021
PubMed

Insights

Brachial plexus birth injury (BPBI) is declining. Early intervention, including surgery, relies on serial examinations, but evidence is limited due to lesion variability.

Area of Science:

  • Pediatric Surgery
  • Neurology
  • Obstetrics

Background:

  • Brachial plexus birth injury (BPBI) incidence is decreasing in the US, now below 1 per 1,000 births.
  • Serial examination is the established method for identifying the need for early intervention in BPBI cases.

Purpose of the Study:

  • To review the current state of early intervention for brachial plexus birth injury.
  • To highlight the surgical techniques and evidence limitations in managing BPBI.

Main Methods:

  • Literature review focusing on studies related to BPBI diagnosis and treatment.
  • Analysis of evidence based on retrospective comparative studies and case series due to lesion heterogeneity.

Main Results:

  • The incidence of BPBI has significantly declined.
  • Effective early treatment necessitates expertise in nerve grafting and nerve transfers.
  • Evidence quality is constrained by the nature of BPBI lesions.

Conclusions:

  • Despite declining incidence, BPBI requires specialized surgical skills for optimal outcomes.
  • Further research with higher evidence levels is needed to guide treatment strategies for diverse BPBI presentations.
Abstract

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