The natural history and management of brachial plexus birth palsy.

Autor: Buterbaugh KL; Division of Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Wood Building Room 2307, Philadelphia, PA, 19104-4318, USA., Shah AS; Division of Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Wood Building Room 2307, Philadelphia, PA, 19104-4318, USA. shaha6@email.chop.edu.
Jazyk: angličtina
Zdroj: Current reviews in musculoskeletal medicine [Curr Rev Musculoskelet Med] 2016 Dec; Vol. 9 (4), pp. 418-426.
DOI: 10.1007/s12178-016-9374-3
Abstrakt: Brachial plexus birth palsy (BPBP) is an upper extremity paralysis that occurs due to traction injury of the brachial plexus during childbirth. Approximately 20 % of children with brachial plexus birth palsy will have residual neurologic deficits. These permanent and significant impacts on upper limb function continue to spur interest in optimizing the management of a problem with a highly variable natural history. BPBP is generally diagnosed on clinical examination and does not typically require cross-sectional imaging. Physical examination is also the best modality to determine candidates for microsurgical reconstruction of the brachial plexus. The key finding on physical examination that determines need for microsurgery is recovery of antigravity elbow flexion by 3-6 months of age. When indicated, both microsurgery and secondary shoulder and elbow procedures are effective and can substantially improve functional outcomes. These procedures include nerve transfers and nerve grafting in infants and secondary procedures in children, such as botulinum toxin injection, shoulder tendon transfers, and humeral derotational osteotomy.
Competing Interests: Kristin L. Buterbaugh and Apurva S. Shah declare that they have no conflict of interest. Human and animal rights and informed consent This article does not contain any studies with human or animal subjects performed by any of the authors.
Databáze: MEDLINE
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