Obstetrical brachial plexus palsy.
Since the days of Hippocrates, scripts have included descriptions of infants who were unable to move their arms. However, it was not until the mid-1700s that an obstetric cause for the paralysis was considered. In 1872, the term obstetrical brachial plexus palsy was coined when a correlation was made between excessive traction on the brachial plexus during delivery and the clinical finding of arm paralysis. Surgical intervention became the norm in the beginning of the 19th century and continued until 1930. Poor outcomes and spontaneous resolution of obstetrical brachial plexus palsy prompted a 40-year span of conservative treatment. By the late 1960s, advances in technology and microsurgical techniques revived interest in surgical intervention in the management of obstetrical brachial plexus palsy. This article focuses on obstetrically caused brachial plexus injury, including risk factors, clinical presentation, and treatment options and outcomes. An understanding of current medical practices and their outcomes also provides a basis on which to develop sound support strategies to help parents who face this dilemma.
Dunham
Elaine A
EA
Shriners Hospital for Children, Springfield, MA, USA.
D020516:Brachial Plexus Neuropathies / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002370:Casts, Surgical; D002648:Child; D019091:Critical Pathways; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010246:Paralysis, Obstetric / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010290:Parents / Q000193:education / Q000523:psychology; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D010808:Physical Examination; D026741:Physical Therapy Modalities; D011187:Posture; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support