Obstetric brachial palsy

  • PARÁLISIS BRAQUIAL OBSTÉTRICA

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.
     

GLENOHUMERAL DYSPLASIA

  • 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.

LINKS

MEDICAL SERVICES

Vall d'Hebron Hospital Campus
Passeig de la Vall d'Hebron, 119-129
08035 Barcelona

Hospital de Nens
Carrer Consell de Cent, 437
08009 Barcelona

Unidad de Cirugía Artroscópica
C/ Beato Tomás de Zumárraga 10 Hospital Vithas San José, 4ª Planta
01008 Vitoria-Gasteiz

Centro Médico Teknon
Carrer de Vilana, 12
08022 Barcelona