Brachial Plexus Birth Palsy-Current Concepts in the Management of Brachial Plexus Birth Palsy

Current Concepts in the Management of Brachial Plexus Birth Palsy

Pdf Summary

Brachial plexus birth palsy (BPBP) is a rare condition that can result in chronic impairment. There are several treatment options available to help improve function in the affected upper extremity, including physiotherapy, microsurgical nerve reconstruction, secondary joint corrections, and muscle transpositions. However, there are still unresolved controversies regarding the natural history of the injury, microsurgical treatment, and secondary shoulder reconstructive surgery in infants with BPBP. Recent literature has improved our understanding of the injury and its treatment. It is recommended that microsurgery and shoulder reconstruction are performed as early as possible in infants with global lesions and Horner's syndrome, although the exact timing for surgery in rupture-type injuries is still debated. Nerve transfers and grafts can be used for nerve reconstruction. The shoulder joint can be affected by internal rotation contracture, glenohumeral deformity, and muscle imbalance. Surgical management of the shoulder may include musculotendinous lengthenings, tendon transfers, joint reductions, and osteotomies to improve function and restore alignment. Imaging techniques such as magnetic resonance imaging and arthrograms can be used to assess joint and bony development. Overall, the management of BPBP is complex and should be tailored to the individual patient based on their specific circumstances. Further research is needed to clarify the optimal management strategies for infants with BPBP.

Keywords

Brachial plexus birth palsy

chronic impairment

physiotherapy

microsurgical nerve reconstruction

shoulder reconstructive surgery

nerve transfers

surgical management

muscle imbalance

imaging techniques

optimal management strategies