From the Research
Brachial plexus birth injury, also known as obstetric brachial plexus palsy, occurs when the network of nerves that sends signals from the spine to the shoulder, arm, and hand (the brachial plexus) is damaged during birth, typically due to excessive traction on the infant's head and neck during a difficult delivery, as noted in a recent study 1. This injury can range from mild stretching (neuropraxia) to complete tearing (avulsion) of the nerves, with common types including Erb's palsy (affecting the upper arm) and Klumpke's palsy (affecting the hand and wrist) 2. Some key points to consider in the management of brachial plexus birth injury include:
- The importance of early diagnosis and intervention, with physical therapy beginning within the first few weeks of life 3
- The potential need for surgical intervention in more severe cases that do not show improvement within 3-6 months 1
- The role of occupational therapy and serial splinting/casting in preventing and correcting contractures 3
- The high rate of spontaneous recovery (66-92%) in mild to moderate cases, with most resolving within the first year of life with appropriate therapy 3 However, severe injuries may result in permanent weakness or paralysis of the affected arm, highlighting the need for prompt and effective treatment to minimize long-term morbidity and mortality, and optimize quality of life 4, 5. In terms of specific treatment approaches, non-surgical interventions, such as physical therapy and botulinum toxin injections, should be the primary course of treatment, with surgery reserved for cases where the patient is deemed unable to recover with other treatments 1. Overall, a comprehensive and multidisciplinary approach to the management of brachial plexus birth injury is essential to achieving optimal outcomes and minimizing the risk of long-term complications 2, 5.