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Spontaneous Recovery of Active Shoulder External Rotation in Patients with Brachial Plexus Birth Injury
Maria Hyttinen1, Henrikki Rönkkö2, Pasi Paavilainen3
1From the Faculty of Medicine and Health Technology.
Plastic and Reconstructive Surgery
|November 20, 2024
Summary
Most brachial plexus birth injury (BPBI) patients with no external rotation (ER) at 3 months recover by age 2. Early elbow flexion and Narakas grade predict ER recovery in BPBI.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Brachial plexus birth injury (BPBI) is a delivery complication affecting newborns.
- Impaired external rotation (ER) of the shoulder is common in BPBI.
- Optimal timing for surgical intervention for ER recovery remains unclear.
Purpose of the Study:
- To investigate spontaneous recovery patterns of active ER in BPBI patients.
- To identify predictors of ER recovery in infants with BPBI.
Main Methods:
- Retrospective analysis of 103 BPBI patients lacking active ER at 3 months.
- Systematic collection of clinical data on recovery.
- Assessment of early recovery indicators (elbow flexion, shoulder abduction, Narakas grade) at 1 month for predictive value.
Main Results:
- 51% of patients achieved spontaneous ER recovery.
- Recovery predominantly occurred by age 2 years (92%), with a plateau thereafter.
- Early elbow flexion and Narakas grade at 1 month were significant predictors of ER recovery.
Conclusions:
- Age 2 years represents a meaningful timeframe for observing spontaneous ER recovery in BPBI.
- Findings inform surgical decision-making for peripheral nerve transfer to enhance ER in BPBI patients.
