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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
Summary
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.
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