Obstetric brachial palsy
BRACHIAL PLEXUS BIRTH PALSY & GLENOHUMERAL DYSPLASIA
Contrary to some nihilistic views on the future of children with Brachial plexus birth palsy, this section outlines how prevention and treatment are both effective and fundamental. Preventing and treating problems arising from BPBP is also a key factor that should be taken into consideration.
BPBP and glenohumeral dysplasia highlights:
BRACHIAL PLEXUS BIRTH PALSY
- Occurs when the collection of nerves around the shoulder is damaged during birth.
- Early surgical consultation is strongly advised.
- Precocious passive joint movements are fundamental, focusing on the external rotation of the shoulder.
- Early surgical repair is recommended for avulsions (3 months of age). Surgical repair for ruptures is recommended at the age of 5 months, if there is no recovery of elbow flexion against gravity.
- Electromyography is useless. Occasionally, MRI may be indicated.
- The aftermath of the shoulder is the predominant motion alteration in children affected with BPBP.
- Early physiotherapy in infants with BPBP prevents further shoulder problems. It must be executed from the beginning by the parents, mainly focusing on passive external rotation exercises.
- Suspect glenohumeral dysplasia if passive shoulder external rotation is not possible.
- Nonsurgical treatment described by Dr Soldado provides patients with better outcomes than surgery, by regaining shoulder external rotation and protecting against loss of internal rotation.
Dr. Francisco Soldado is a specialist in children's upper extremity problems and in the reconstruction with microsurgical techniques of the extremities of children.
In his efforts to perfect treatment strategies and techniques, he has collaborated with multiple reference centers around the world.
Vall d'Hebron Hospital Campus
Passeig de la Vall d'Hebron, 119-129
Hospital de Nens
Carrer Consell de Cent, 437
Unidad de Cirugía Artroscópica
C/ Beato Tomás de Zumárraga 10 Hospital Vithas San José, 4ª Planta
Centro Médico Teknon
Carrer de Vilana, 12