[Surgical treatment of perinatal brachial plexus palsy in children--late surgical technique].
Apart from the possibilities to predict and eliminate the risk factors (especially in highly developed countries) the perinatal brachial plexus palsy (PBPP) still constitutes severe labor complications. PBPP treatment may be divided into conservative and operative categories. It is considered that the time necessary to regain functioning of brachial and ulnar articulations in children with BPPP (treated conservatively and surgically) amounts to 2 years approximately. Therefore, second late surgical technique of muscles and tendons of paralysed limb is performed in children at this age and older. It is accompanied by orthopaedic treatment and therapeutic rehabilitation, the aim of which is the improvement of its efficiency. The choice of proper treatment method (especially when chronic paralysis is observed) is conditioned by disorders of functioning in particular parts of a limb. Most frequently detected impairments resulting from BPPP which are treated surgically are disorders of shoulder functioning which occurs in 50% of plexus palsies. Ulnar dysfunctions constitute 15%, forearm dysfunctions amount to 15% and finally hand dysfunction is equal to 10%. Dysfunctioning of the upper limb constitutes 10%. Its reconstruction procedure is not necessary. The positive aspect of surgical reconstruction in patients with PBPP is not only improvement of paralysed limb functioning but also of patient's self-evaluation.
Chochowska
Małgorzata
M
Pracownia Elektrodiagnostyki Medycznej, Katedra Profilaktyki Zdrowotnej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu. chochoma@amp.edu.pl
Mielcarska
Marta
M
Zgorzalewicz-Stachowiak
Małgorzata
M
Romanowski
Leszek
L
D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000601:surgery*; D004550:Elbow / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010243:Paralysis / Q000209:etiology / Q000517:prevention & control* / Q000534:rehabilitation; D018743:Perinatal Care; D019651:Plastic Surgery Procedures; D012086:Reoperation; D012782:Shoulder / Q000503:physiopathology / Q000601:surgery