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Evaluation of surgical outcomes of obstetric brachial plexus birth injury: clinical and electrophysiological study

Abstract

Background

Obstetric brachial plexus birth injury (OBPBI) is a relatively common form of birth injury that might lead to a weighty physical disability. Early microsurgical intervention for properly selected patients will result in maximal functional benefit that couldn’t be otherwise obtained. However, the outcomes of different microsurgical techniques need to be further evaluated and compared.

Aim

To evaluate the outcomes of different microsurgical techniques performed in patients with OBPBI.

Patients & Methods

Twenty-eight patients with OBPBI meeting the criteria for surgical intervention were included in the study. Preoperative and one year postoperative clinical and electrophysiological assessments were done.

Results

Thirteen (46.4%) of the studied patients were males and 15 (53.6%) were females. The mean age of patients in the study was 8.64 months ± 4.40; ranging between (3.0 – 16.0 months),7 patients had Horner syndrome.C5 and C6+/-C7 roots affection was the most frequent lesion ,patients who underwent neurotization recovered earlier than patients who underwent nerve grafting ,on the other hand nerve grafting resulted in more significant postoperative improvement after a 12 months follow up period.

Conclusions

The current study provided additional evidence that the earlier the surgical intervention in OBPBI, the better the outcomes. Neurotization results in earlier functional recovery in patients with OBPBI than nerve grafting reconstructive techniques. On the other hand, nerve grafting was superior to neurotization regarding the degree of improvement. Postoperative electrophysiological follow-up can be done using the CMAP amplitude and AUC percentages reflecting the percentage of viable axons.

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Correspondence to Marwa M. Hassan MD.

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Mohasseb, D.F., Hassan, M.M., Semaya, A.E. et al. Evaluation of surgical outcomes of obstetric brachial plexus birth injury: clinical and electrophysiological study. Egypt Rheumatol Rehabil 46, 229–236 (2019). https://doi.org/10.4103/err.err_4_19

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