title: Results of nerve reconstructions in treatment of obstetrical brachial plexus injuries.
abstract: BACKGROUND
  The aim of this study was to evaluate the results achieved using various surgical techniques in patients with partial and total obstetrical brachial plexus palsy.
  
  
  METHODS
  From 2000 to 2013, 33 patients with obstetrical brachial plexus injury underwent surgery. Twenty had follow-up periods greater than 24 months and met the criteria for inclusion in the study. All patients were evaluated using the Active Movement Scale.
  
  
  RESULTS
  The outcomes of different nerve reconstructive procedures including nerve transfers, nerve grafting after neuroma resection and end-to-side neurorrhaphy are presented. The overall success rate in upper plexus birth injury was 80 % in shoulder abduction, 50 % in external rotation and 81.8 % in elbow flexion with median follow-ups of 36 months. Success rate in complete paralysis was 87 % in finger and thumb flexion, 87 % in shoulder abduction and 75 % in elbow flexion; the median follow-up was 46 months. Useful reanimation of the hand was obtained in both patients who underwent end-to-side neurotization.
  
  
  CONCLUSIONS
  Improved function can be obtained in infants with obstetrical brachial plexus injury with early surgical reconstruction.
authors.affiliation: Department of Neurosurgery, 3rd Faculty of Medicine, Charles University, Faculty Hospital Královské Vinohrady, Prague, Czech Republic.
authors.forename: Libor
authors.initials: L
authors.lastname: Mencl
authors.forename: Petr
authors.initials: P
authors.lastname: Waldauf
authors.forename: Pavel
authors.initials: P
authors.lastname: Haninec
mesh_terms: D001720:Birth Injuries / Q000150:complications / Q000601:surgery*; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016067:Nerve Transfer / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods*; D011843:Radiculopathy / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome