Obstetric brachial plexus palsy: treatment strategy, long-term results, and prognosis. 2009

Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
Arbeitsbereich Plastische und Handchirurgie, Franziskushospital Aachen, Aachen, Germany. jorg.bahm@belgacom.net

BACKGROUND Obstetric brachial plexus palsy is rare, but the limb impairments are manifold and often long-lasting. Physiotherapy, microsurgical nerve reconstruction, secondary joint corrections, and muscle transpositions are employed with success. The role of conservative and operative treatment options should be regularly reviewed. METHODS Selective literature review (evidence levels 3 and 4) and analysis of personal clinical operative and scientific experience over the past 15 years. RESULTS Children with upper and total plexus palsy displaying nerve root avulsions and/or -ruptures are treated today by early primary nerve reconstruction in the first few months of life followed by secondary corrections, with good functional results. The late complications, with muscle weakness, impaired motion patterns, and joint dysplasia, are often underrated. CONCLUSIONS The potential for scientific analysis is limited, due to the rarity and interindividual variability of the lesions and the varying effects on function and growth. Expectations and compliance are different in every patient. Surgical techniques are not yet standardized. Knowledge of the consequences for joint growth and congruence is inadequate. Today, functional improvement can be achieved by surgery in most clinical manifestations of obstetric brachial plexus palsy, within the framework of an interdisciplinary treatment concept.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D010291 Paresis A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for PARALYSIS (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis (see NEUROSYPHILIS). "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as PARAPARESIS. Hemiparesis,Muscle Paresis,Brachial Paresis,Crural Paresis,Lower Extremity Paresis,Monoparesis,Muscular Paresis,Upper Extremity Paresis,Brachial Pareses,Crural Pareses,Extremity Pareses, Lower,Extremity Pareses, Upper,Extremity Paresis, Lower,Extremity Paresis, Upper,Hemipareses,Lower Extremity Pareses,Monopareses,Muscle Pareses,Muscular Pareses,Pareses,Pareses, Brachial,Pareses, Crural,Pareses, Lower Extremity,Pareses, Muscle,Pareses, Muscular,Pareses, Upper Extremity,Paresis, Brachial,Paresis, Crural,Paresis, Lower Extremity,Paresis, Muscle,Paresis, Muscular,Paresis, Upper Extremity,Upper Extremity Pareses
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D020516 Brachial Plexus Neuropathies Diseases of the cervical (and first thoracic) roots, nerve trunks, cords, and peripheral nerve components of the BRACHIAL PLEXUS. Clinical manifestations include regional pain, PARESTHESIA; MUSCLE WEAKNESS, and decreased sensation (HYPESTHESIA) in the upper extremity. These disorders may be associated with trauma (including BIRTH INJURIES); THORACIC OUTLET SYNDROME; NEOPLASMS; NEURITIS; RADIOTHERAPY; and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp1351-2) Brachial Plexopathy,Erb Paralysis,Klumpke Paralysis,Brachial Plexus Diseases,Brachial Plexus Disorders,Dejerine-Klumpke Palsy,Erb's Palsy,Erb-Duchenne Paralysis,Klumpke's Palsy,Lower Brachial Plexus Neuropathy,Lower Brachial Plexus Palsy,Middle Brachial Plexus Neuropathy,Paralysis of the Lower Brachial Plexus,Upper Brachial Plexus Neuropathy,Brachial Plexus Disease,Brachial Plexus Disorder,Brachial Plexus Neuropathy,Dejerine Klumpke Palsy,Erb Duchenne Paralysis,Erb Palsy,Erb Paralyses,Erb's Palsies,Erb-Duchenne Paralyses,Erbs Palsy,Klumpke Palsy,Klumpkes Palsy,Neuropathies, Brachial Plexus,Neuropathy, Brachial Plexus,Palsies, Erb's,Palsy, Dejerine-Klumpke,Palsy, Erb's,Palsy, Klumpke's,Paralyses, Erb,Paralyses, Erb-Duchenne,Paralysis, Erb,Paralysis, Erb-Duchenne,Paralysis, Klumpke,Plexopathies, Brachial,Plexopathy, Brachial,Plexus Disease, Brachial,Plexus Diseases, Brachial,Plexus Disorder, Brachial,Plexus Disorders, Brachial,Plexus Neuropathies, Brachial,Plexus Neuropathy, Brachial

Related Publications

Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
January 2010, Microsurgery,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
February 2002, Journal of hand surgery (Edinburgh, Scotland),
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
November 1986, Hand clinics,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
June 2010, Developmental medicine and child neurology,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
January 1996, Journal of pediatric orthopedics. Part B,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
January 2007, The Journal of bone and joint surgery. American volume,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
August 2009, The Journal of hand surgery, European volume,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
April 2004, Plastic and reconstructive surgery,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
March 2003, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...,
Jörg Bahm, and Claudia Ocampo-Pavez, and Catherine Disselhorst-Klug, and Bernd Sellhaus, and Joachim Weis
January 2004, Medicina (Kaunas, Lithuania),
Copied contents to your clipboard!