Update on management of pediatric brachial plexus palsy.
This manuscript will review the literature and focus on the present controversies regarding the natural history, microsurgical treatment, and secondary shoulder reconstructive surgery in infants with brachial plexus birth palsies. Surgical indications, expected outcomes, and complications will be addressed. The controversy regarding the timing of microsurgery in extraforaminal ruptures will be addressed in detail. The developments in assessment and care of glenohumeral deformity with magnetic resonance imaging scans, arthroscopic and open reductions, and tendon transfers about the shoulder will be discussed. Recommendations for microsurgery and shoulder reconstruction will be based on the present evidence from the literature.
Waters
Peter M
PM
Harvard Medical School and Children's Hospital Boston, Boston, Massachusetts 02115, USA. peter.waters@tch.harvard.edu
D001720:Birth Injuries / Q000601:surgery*; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D003286:Contracture / Q000209:etiology / Q000503:physiopathology; D004551:Elbow Joint / Q000503:physiopathology; D004576:Electromyography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008866:Microsurgery; D009431:Neural Conduction; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology*; D013709:Tendon Transfer; D014955:Wrist Joint / Q000503:physiopathology