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Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 4/2016

01-12-2016 | Pediatric Orthopedics (B Heyworth, Section Editor)

The natural history and management of brachial plexus birth palsy

Authors: Kristin L. Buterbaugh, Apurva S. Shah

Published in: Current Reviews in Musculoskeletal Medicine | Issue 4/2016

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Abstract

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.
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Metadata
Title
The natural history and management of brachial plexus birth palsy
Authors
Kristin L. Buterbaugh
Apurva S. Shah
Publication date
01-12-2016
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 4/2016
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-016-9374-3

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