Brachial Plexus Injuries Best Treated Surgically


FAJARDO, P.R. — Surgery is the best option for treatment in children with global brachial plexus birth palsies, a study suggests.

Final shoulder function in 36 infants with such injuries who underwent surgery was fair in 22% of patients, satisfactory in 50%, good in 22%, and excellent in 6%. Final shoulder function was poor in 100% of 12 control patients who did not undergo surgery, Patricia DiTaranto, M.D., said at the annual meeting of the American Association for Hand Surgery.

Hand function in the surgery patients was fair in 19%, satisfactory in 58%, good in 17%, and excellent in 6%. Hand function in those who did not undergo surgery was poor in 25% and fair in 75%, said Dr. DiTaranto of Miami Children's Hospital.

Functional outcomes were determined using the Gilbert-Raimondi system, she noted. The children studied were born at a single institution over a 4-year period and were followed for at least 2.5 years. All had global brachial plexus injuries at birth, and the clinical findings persisted at 6-month follow-up. Those in the surgery group underwent surgical reconstruction of the brachial plexus; the surgical strategy of nerve repair and transfer focused on recovery of shoulder stability and hand function, Dr. DiTaranto noted.

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