Brachial plexus birth injury: advances and controversies

• Published in: The Journal of hand surgery, European volume Vol. 49; no. 6; p. 747
• Main Authors: Leblebicioğlu, Gürsel, Pondaag, Willem
• Format: Journal Article
• Language: English
• Published: England 01.06.2024
• Subjects: Birth Injuries - surgery; Brachial Plexus - injuries; Brachial Plexus Neuropathies - etiology; Brachial Plexus Neuropathies - surgery; Humans; Neonatal Brachial Plexus Palsy - surgery; Nerve Transfer - methods; Physical Therapy Modalities; nerve transfers; magnetic resonance imaging; timing of surgery; Brachial plexus birth injury; nerve reconstruction; therapy
• ISSN: 2043-6289
• DOI: 10.1177/17531934241231173

While there is considerable spontaneous recovery in most cases of brachial plexus birth injury, many children are left with significant problems that may lead to lifelong functional limitations, loss of work and social isolation. Detailed treatment with the right strategy can provide very valuable improvement in function. Over the past few years, the clinical approach to brachial plexus birth palsy has entered a new era in both diagnostic and surgical treatment methods. This article reviews four areas of management, the role of imaging in defining the severity of the injury, the optimal timing of for nerve exploration and reconstruction in appropriate cases, the advantages and potential complications of nerve transfers, and the role of physiotherapy. Available evidence is considered. Although it is difficult to make clear and precise inferences on a subject where there are many variables and considerable uncertainties, some currently accepted views will be summarized. V.