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[Surgical treatment of children with brachial plexus paralysis]
J A Grossman1, L E Ramos, M Tidwell
1Brachial Plexus Palsy Center, Miami Children's Hospital, Florida 33155, USA.
Insights
This review details surgical techniques for obstetrical brachial plexus palsy (OBPP) in infants and children. Our approach aims to improve functional outcomes through nerve repair and reconstruction of secondary deformities.
Area of Science:
- Pediatric Surgery
- Neurology
- Orthopedics
Context:
- Obstetrical brachial plexus palsy (OBPP) is a birth-related nerve injury affecting infants.
- Early surgical intervention is crucial for optimal functional recovery.
- Secondary deformities can arise, requiring further reconstructive procedures.
Purpose:
- To outline a comprehensive surgical strategy for managing OBPP.
- To describe techniques for primary nerve repair and secondary reconstruction.
- To maximize functional outcomes in affected children.
Summary:
- Surgical options for OBPP include neuroma excision, nerve grafting, neurolysis, and neurotization.
- Reconstruction of shoulder, forearm, and hand deformities utilizes soft tissue and skeletal procedures.
- The described approach focuses on maximizing functional results in pediatric patients.
Impact:
- Provides a guide for surgical management of OBPP.
- Aims to improve long-term functional abilities in children with nerve injuries.
- Contributes to the understanding of reconstructive strategies for OBPP.
Objective And Methods:
A variety of surgical procedures exist for early repair of the nerve injury in obstetrical brachial plexus palsy, including neuroma excision and nerve grafting, neurolysis and neurotization. Secondary deformities of the shoulder, forearm, and hand can similarly be reconstructed using soft tissue and skeletal procedures. This review describes our surgical approach to maximize the ultimate functional outcome in infants and children with obstetrical brachial plexus palsy.