title: Our experience with surgical treatment of perinatal brachial plexus palsy--results in different types of lesions.
abstract: BACKGROUND
  Perinatal brachial plexus palsies can be divided into upper (C5-C6), upper-middle (C5-C6-C7) and total injuries (C5-Th1). The study aimed to evaluate the results of surgical repair in the different types of palsies.
  
  
  METHODS
  The patient population comprised 80 children who underwent primary repair of the brachial plexus (external neurolysis, internal neurolysis, direct neurorrhaphy, nerve grafts, extraanatomical intraplexus reconstruction, extraanatomical extraplexus reconstruction). 31 patients were additionally subjected to 39 tenomioplasty procedures. Widely recognised assessment scales were used to evaluate the outcome of surgical treatment of different types of palsies in 70 patients.
  
  
  RESULTS
  Good and very good post-operative function of the glenohumeral and elbow joints was demonstrated in all patients with upper palsy. In the group of upper-middle injuries, 61.5% of patients presented good and very good function of the shoulder joint and 76.9% had good function of the elbow. In subjects with total brachial plexus palsy, good function of the glenohumeral was demonstrated by 51.2%, good function of the elbow by 61% and 53.6% presented with a functionally useful hand.
  
  
  CONCLUSIONS
  1. While surgical repair may be indicated in brachial plexus injuries at all levels, it is usually inevitable in total and upper-middle palsies. 2. The surgical outcome depends on the extent of baseline damage to the brachial plexus, with the best prognosis in insolated upper palsies.
authors.affiliation: Katedra Chirurgii Urazowej, Klinika Chirurgii Urazowej i Chirurgii Ręki, Akademia Medyczna, Wrocław. chi ru raz@chu raz.am.wroc.pl
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gosk
authors.forename: Roman
authors.initials: R
authors.lastname: Rutowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Urban
authors.forename: Roman
authors.initials: R
authors.lastname: Wiącek
authors.forename: Piotr
authors.initials: P
authors.lastname: Mazurek
mesh_terms: D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000145:classification / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008866:Microsurgery / Q000379:methods*; D053580:Muscle Strength; D016067:Nerve Transfer / Q000379:methods; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D034941:Upper Extremity / Q000294:innervation*