Brachial plexus birth injury in children and adolescents: A current concepts review

Taylor Shackleford1, Kevin J Little1,2

  • 1Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Insights

Brachial plexus birth injuries (BPBI) impact patients significantly. This review details current concepts for treating BPBI, focusing on examination, surgical indications, and long-term outcomes for pediatric orthopedic providers.

Area of Science:

  • Pediatric Orthopedics
  • Neonatal Care
  • Neurology

Background:

  • Brachial plexus birth injuries (BPBI) are rare but impactful.
  • Specialty centers manage complex BPBI cases.
  • Understanding BPBI is crucial for pediatric orthopedic providers.

Purpose of the Study:

  • To review current concepts in BPBI treatment.
  • To focus on clinical examination and operative indications.
  • To discuss early surgical interventions and long-term sequelae.

Main Methods:

  • Literature review of BPBI treatment.
  • Synthesis of current clinical and surgical concepts.
  • Focus on pediatric orthopedic management.

Main Results:

  • Detailed examination techniques for BPBI.
  • Criteria for operative intervention in BPBI.
  • Insights into early surgical timing and outcomes.
  • Analysis of long-term musculoskeletal complications.

Conclusions:

  • Comprehensive understanding of BPBI natural history is vital.
  • Timely surgical intervention improves outcomes.
  • Long-term musculoskeletal sequelae require ongoing management.

Related Concept Videos

Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
3.5K
Arteries of the Upper Limbs01:12

Arteries of the Upper Limbs

The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
3.0K
Spinal Nerves: Plexus II01:21

Spinal Nerves: Plexus II

The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
3.2K
Flail Chest-I01:24

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
1.0K
Changes in the Appendicular Skeleton with Age01:09

Changes in the Appendicular Skeleton with Age

The upper and lower limb initially develops as a small bulge called a limb bud, which appears on the lateral side of the early embryo. The upper limb bud appears near the end of the fourth week of development, with the lower limb bud appearing shortly after.
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
4.0K
Neurogenesis and Regeneration of Nervous Tissue01:15

Neurogenesis and Regeneration of Nervous Tissue

In the CNS, neurogenesis, the birth of new neurons from stem cells, is limited to the hippocampus in adults. In other regions of the brain and spinal cord, neurogenesis is almost non-existent due to inhibitory influences from neuroglia, especially oligodendrocytes, and the absence of growth-stimulating cues. The myelin produced by oligodendrocytes in the CNS inhibits neuronal regeneration. Furthermore, astrocytes proliferate rapidly after neuronal damage, forming scar tissue that physically...
2.0K