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Results of nerve reconstructions in treatment of obstetrical brachial plexus injuries

  • Case Report - Pediatrics
  • Published:
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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.

Conclusion

Improved function can be obtained in infants with obstetrical brachial plexus injury with early surgical reconstruction.

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Acknowledgments

This study was supported by the Charles University in Prague, PRVOUK P34 and 260045/SVV/2014.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Neurosurgery, 3rd Faculty of Medicine, Charles University, Faculty Hospital Královské Vinohrady, Prague, Czech Republic

    Libor Mencl, Petr Waldauf & Pavel Haninec

Authors
  1. Libor Mencl
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  2. Petr Waldauf
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  3. Pavel Haninec
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Corresponding author

Correspondence to Pavel Haninec.

Additional information

Libor Mencl, MD: Conception and design of the study; analysis and interpretation of the data.

Petr Waldauf, MD: Statistical analysis.

Prof. Pavel Haninec, MD, PhD: Conception and design of the study; study supervision.

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Mencl, L., Waldauf, P. & Haninec, P. Results of nerve reconstructions in treatment of obstetrical brachial plexus injuries. Acta Neurochir 157, 673–680 (2015). https://doi.org/10.1007/s00701-015-2347-2

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  • DOI: https://doi.org/10.1007/s00701-015-2347-2

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