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Primary Nerve Reconstruction in Brachial Plexus Birth Palsy: Current Concepts

Volume 7 | Issue 1 | January-April 2021 | Page: 37-44 | Parag B. Lad, Nischal Naik, Bharat K. Kadadi, P. S. Bhandari, Mukund R. Thatte

Authors: Parag B. Lad D Ortho., MS Ortho. [1], Nischal Naik M.Ch. [2], Bharat K. Kadadi MS Ortho. [3],
P. S. Bhandari M.Ch. [4], Mukund R. Thatte M.Ch. [5]

[1] Jupiter Hospital, Thane, Maharashtra, India.
[2] Divyam Hospital, Ahmedabad, Gujarat, India.
[3] Bengaluru Hand Centre & Manipal Hospitals, Bangalore, Karnataka, India.
[4] Brij Lal Super specialty Hospital, Haldwani, Nainital, Uttarakhand, India.
[5] Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Mukund R Thatte,
Plastic Surgeon, Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra, India.
E-mail: mthatte@gmail.com


Abstract

This article discusses the role of primary nerve surgery for Brachial Plexus Birth Palsy (BPBP). Spontaneous recovery in brachial plexus birth palsy is known and in such cases the prognosis is good. However, the incidence of such recovery is 30 – 90%. In some infants however, the course of motor recovery is inadequate necessitating nerve repair. BPBP presents clinically as a lower motor neuron type of upper limb monoplegia at birth. Indications of primary nerve reconstruction or distal nerve transfer, the technique of exploration of brachial plexus, common anatomical variations and the methods for identification of intact roots are discussed in detail.
Keywords: Primary nerve reconstruction, Brachial Plexus Birth Palsy (BPBP), Nerve transfer, co-contractions, Brachial plexus surgery.


References 

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How to Cite this Article:  Lad PB, Naik N, Kadadi BK, Bhandari PS, Thatte MR | Primary Nerve Reconstruction in Brachial Plexus Birth Palsy: Current Concepts | International Journal of Paediatric Orthopaedics | January-April 2021; 7(1): 37-44.

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Clinical Examination and Early Management of Brachial Plexus Birth Palsy (BPBP)

Volume 7 | Issue 1 | January-April 2021 | Page: 28-36 | Gaurav Gupta, Tejas Patel, Chasanal Rathod, Amila Shashanka Ratnayake, Maulin M Shah, Bharat K. Kadadi

Authors: Gaurav Gupta MBBS, MS Ortho. [1], Tejas Patel PT, C/NDT, SI. [2], Chasanal Rathod MBBS, MS Ortho. [3], Amila S. Ratnayake MBBS, MS MRCS(Ed) [4], Maulin M. Shah MBBS, MS Ortho. [5], Bharat K. Kadadi MBBS, MS Ortho. [6]

[1] Consultant, Paediatric Orthopaedic Surgeon, Child Ortho Clinic, New Delhi
[2] Consultant, Paediatric Physiotherapist, Sparsh Paediatric Rehabilitation Clinic, Ahmedabad, Gujrat, India.
[3] Consultant Pediatric Orthopedic Surgeon, NHSRCC Children’s Hospital, Mumbai, Maharashtra, India.
[4] Plastic & Reconstructive Surgeon, National Hospital Kandy, Sri Lanka
[5] Consultant, Paediatric Orthopaedic Surgeon, OrthoKids Clinic, Ahmedabad, Gujrat, India.
[6] Bengaluru Hand Centre & Manipal Hospitals, Bangalore, Karnataka, India.

Address of Correspondence
Dr. Maulin M Shah,
Consultant, Paediatric Orthopaedic Surgeon, OrthoKids Clinic, Ahmedabad, Gujrat, India.
E-mail: maulinmshah@gmail.com


Abstract

Brachial Plexus Birth Palsy (BPBP) is defined as a flaccid paralysis of the upper limb that occurs as a result of traction injury to the brachial plexus during the process of birth. The incidence of BPBP has been estimated between 0.4% to 5.1% in various studies worldwide.
A precise clinical examination is the key to ascertain the type of injury, prognosticate the outcome and forecast the probable need of surgical intervention. A detailed clinical examination methodology and important signs directing to the intervention are described in this paper. The importance of regular clinical follow up has been emphasised. Early rehabilitation of infants with BPBP and physiotherapy protocols are discussed.

Keywords:


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How to Cite this Article: Gupta G, Patel T, Rathod C, Ratnayake AS, Shah MM | Clinical examination and Early Management of Brachial Plexus Birth Palsy (BPBP) | International Journal of Paediatric Orthopaedics | January-April 2021; 7(1): 28-36.

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