Outcome following nonoperative treatment of brachial plexus birth injuries.
Ninety-one infants who sustained a brachial plexus birth injury were treated with only physical and occupational therapy. The children were evaluated at 3-month intervals and followed for a minimum of 2 years. Sixty-three children with an upper or upper-middle plexus injury recovered good to excellent shoulder and hand function. In all of these children, critical marker muscles recovered M4 by 6 months of age. Twelve infants sustained a global palsy, with critical marker muscles remaining at M0-M1 at 6 months, resulting in a useless extremity. Sixteen infants with upper and upper-middle plexus injuries failed to recover greater than M1-M2 deltoid and biceps by 6 months, resulting in a very poor final outcome. These data provide useful guidelines for selection of infants for surgical reconstruction to improve ultimate outcome.
DiTaranto
Patricia
P
Department of Orthopedics, Hospital Materno Infantil, Mar del Plata, Argentina.
Campagna
Liliana
L
Price
Andrew E
AE
Grossman
John A I
JA
D001720:Birth Injuries; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D005121:Extremities / Q000503:physiopathology; D005500:Follow-Up Studies; D006225:Hand / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D012038:Regeneration / Q000502:physiology*; D012720:Severity of Illness Index; D012782:Shoulder / Q000502:physiology*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy