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Neurological recovery in obstetric brachial plexus injuries: an historical cohort study

Published online by Cambridge University Press:  26 January 2004

Agnes F Hoeksma
Affiliation:
Department of Rehabilitation Medicine, Academic Medical Centre, Amsterdam, the Netherlands.
Anne Marie ter Steeg
Affiliation:
Rehabilitation Centre Rijndam, Rotterdam, the Netherlands.
Rob GHH Nelissen
Affiliation:
Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
Willem JR van Ouwerkerk
Affiliation:
Department of Neurosurgery, Academic Medical Centre, Amsterdam, the Netherlands.
Gustaaf J Lankhorst
Affiliation:
Department of Rehabilitation Medicine, Academic Medical Centre, Amsterdam, the Netherlands.
Bareld A de Jong
Affiliation:
Department of Rehabilitation Medicine, Academic Medical Centre, Amsterdam, the Netherlands.
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Abstract

An historical cohort study was conducted to investigate the rate and extent of neurological recovery in obstetric brachial plexus injury (OBPI) and to identify possible prognostic factors in a cohort of children with OBPI from birth to 7 years. All children (n=56; 31 females, 25 males) with OBPI were evaluated at fixed time intervals by one examiner. They underwent a final neurological examination at a mean age of 3 years 10 months (range 1 to 7 years). Neurological outcome was not as favourable as is often reported: complete neurological recovery occurred in 37 out of 56 children (66%). In half of these there was delayed recovery, in which case complete neurological recovery was assessed from 1.5 to 16 months of age (median age 6.5 months, SD 4.2 months). External rotation and supination were the last to recover and recovered the least. Although biceps function at three months was considered to be the best indicator for operative treatment, external rotation and supination were found to be better in predicting eventual complete recovery. Initial symptoms directly post partum were not found to be prognostic. Functional outcome was mainly reported to be good.

Type
Original Articles
Copyright
© 2004 Mac Keith Press

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