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Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers.
Microsurgery 2008; 28(4):252-61M

Abstract

Birth brachial plexus injury usually affects the upper roots. In most cases, spontaneous reinnervation occurs in a variable degree. This aberrant reinnervation leaves characteristic deformities of the shoulder, elbow, forearm, wrist, and hand. Common sequelae are the internal rotation and adduction deformity of the shoulder, elbow flexion contractures, forearm supination deformity, and lack of wrist extension and finger flexion. Nowadays, the strategy in the management of obstetrical brachial plexus palsy focuses in close follow-up of the baby up to 3-6 months and if there are no signs of recovery, microsurgical repair is indicated. Nonetheless, palliative surgery consisting of an ensemble of secondary procedures is used to further improve the overall function of the upper extremity in patients who present late or fail to improve after primary management. These secondary procedures include transfers of free vascularized and neurotized muscles. We present and discuss our experience in treating early and/or late obstetrical palsies utilizing the above-mentioned microsurgical strategy and review the literature on the management of brachial plexus birth palsy.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece. vekrismd@otenet.grNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18381657

Citation

Vekris, Marios D., et al. "Management of Obstetrical Brachial Plexus Palsy With Early Plexus Microreconstruction and Late Muscle Transfers." Microsurgery, vol. 28, no. 4, 2008, pp. 252-61.
Vekris MD, Lykissas MG, Beris AE, et al. Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers. Microsurgery. 2008;28(4):252-61.
Vekris, M. D., Lykissas, M. G., Beris, A. E., Manoudis, G., Vekris, A. D., & Soucacos, P. N. (2008). Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers. Microsurgery, 28(4), pp. 252-61. doi:10.1002/micr.20493.
Vekris MD, et al. Management of Obstetrical Brachial Plexus Palsy With Early Plexus Microreconstruction and Late Muscle Transfers. Microsurgery. 2008;28(4):252-61. PubMed PMID: 18381657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers. AU - Vekris,Marios D, AU - Lykissas,Marios G, AU - Beris,Alexandros E, AU - Manoudis,Grigorios, AU - Vekris,Anastasios D, AU - Soucacos,Panayiotis N, PY - 2008/4/3/pubmed PY - 2008/6/24/medline PY - 2008/4/3/entrez SP - 252 EP - 61 JF - Microsurgery JO - Microsurgery VL - 28 IS - 4 N2 - Birth brachial plexus injury usually affects the upper roots. In most cases, spontaneous reinnervation occurs in a variable degree. This aberrant reinnervation leaves characteristic deformities of the shoulder, elbow, forearm, wrist, and hand. Common sequelae are the internal rotation and adduction deformity of the shoulder, elbow flexion contractures, forearm supination deformity, and lack of wrist extension and finger flexion. Nowadays, the strategy in the management of obstetrical brachial plexus palsy focuses in close follow-up of the baby up to 3-6 months and if there are no signs of recovery, microsurgical repair is indicated. Nonetheless, palliative surgery consisting of an ensemble of secondary procedures is used to further improve the overall function of the upper extremity in patients who present late or fail to improve after primary management. These secondary procedures include transfers of free vascularized and neurotized muscles. We present and discuss our experience in treating early and/or late obstetrical palsies utilizing the above-mentioned microsurgical strategy and review the literature on the management of brachial plexus birth palsy. SN - 1098-2752 UR - https://www.unboundmedicine.com/medline/citation/18381657/Management_of_obstetrical_brachial_plexus_palsy_with_early_plexus_microreconstruction_and_late_muscle_transfers_ L2 - https://doi.org/10.1002/micr.20493 DB - PRIME DP - Unbound Medicine ER -