Brachial Plexus Birth Palsy: Rationale for a Multicenter Prospective Study

ABSTRACT

While the majority of patients with brachial plexus birth palsy (BPBP) demonstrate spontaneous recovery, some will have persistent neurological deficits and functional limitations. Microsurgical repair and/or reconstruction of the brachial plexus are often recommended for these patients; however, the optimal timing of microsurgery is unknown. Furthermore, the long-term outcomes of microsurgery, as compared with natural history and secondary reconstructive surgery, are unknown. The purpose of this article is to present the rationale for the multicenter prospective study of the treatment of BPBP. The current study protocol is provided.

Brachial plexus birth palsy - multicenter prospective study

REFERENCES

• 1 Smellie W. A Collection of Preternatural Cases and Observations in Midwifery. Edited. London; Wilson and Durham 1764
• 2 Erb W H. Veber eine eigen thumliche localization von lahmungen im plexus brachialis.  Verh Dtsch Natur Med. 1874;  2 130-161
• 3 Duchenne G B. De l’électrisation localisée et deo son application à la pathologie et à la thérapeutique. 3rd ed. Paris; Balliere 1872: 337-382
• 4 Klumpke A. Contribution à l’étude des paralyses radiculaires du plexus brachiali: paralyses radiculaires totales, paralyses radiculaires inférieurs, de la participation du fillets sympathetique oculo-papillaires dans ces paralyses.  Rev Med. 1885;  5 591-616 738-790
• 5 Bayne L G, Costas B L, Lourie G M. The upper limb. In: Morrissy RT, Weinstein SL Lovell and Winter's Pediatric Orthopaedics, 4th ed. Philadelphia; Lippincott-Raven 1996: 826-828
• 6 Waters P M. Obstetric brachial plexus injuries: evaluation and management.  J Am Acad Orthop Surg. 1997;  5 205-214
• 7 Geutjens G, Gilbert A, Helsen K. Obstetric brachial plexus palsy associated with breech delivery: a different pattern of injury.  J Bone Joint Surg Br. 1996;  78 303-306
• 8 Greenwald A G, Schute P C, Shiveley J L. Brachial plexus birth palsy: a 10-year report on the incidence and prognosis.  J Pediatr Orthop. 1984;  4 689-692
• 9 Adler J B, Patterson Jr R L. Erb's palsy. Long-term results of treatment in eighty-eight cases.  J Bone Joint Surg Am. 1967;  49 1052-1064
• 10 Hardy A E. Birth injuries of the brachial plexus: incidence and prognosis.  J Bone Joint Surg Br. 1981;  63 98-101
• 11 Gilbert A, Tassin J L. Réparation chirurgicale du plexus brachial dans la paralysie obstétricale.  Chirurgie. 1984;  110 70-75
• 12 Michelow B J, Clarke H M, Curtis C G, Zuker R M, Seifu Y, Andrews D F. The natural history of obstetrical brachial plexus palsy.  Plast Reconstr Surg. 1994;  93 675-681
• 13 Specht E. Brachial plexus palsy in the newborn: incidence and prognosis.  Clin Orthop. 1975;  110 32-34
• 14 Waters P M. Comparison of the natural history, the outcome of microsurgical repair, and the outcome of operative reconstruction in brachial plexus birth palsy.  J Bone Joint Surg Am. 1999;  81 649-659
• 15 Boome R S, Kaye J C. Obstetric traction injuries of the brachial plexus: natural history, indications for surgical repair and results.  J Bone Joint Surg Br. 1988;  70 571-576
• 16 Tassin J L. Paralysies obstetricales du plexus brachial: évolution spontanée, résultats des interventions réparatrices process. Université Paris VII 1983
• 17 Taylor A S. Brachial birth palsy and injuries of type in adults.  Surg Gynecol Obstet. 1920;  30 494-502
• 18 Laurent J P, Lee R T, Shenaq S, Parke J T, Solis I S, Kowalik L. Neurosurgical correction of upper brachial plexus birth injuries.  J Neurosurg. 1993;  79 197-203
• 19 Clarke H M, Curtis C G. An approach to obstetrical brachial plexus injuries.  Hand Clin. 1995;  11 563-580
• 20 Al-Qattan M M. The outcome of Erb's palsy when the decision to operate is made at 4 months of age.  Plast Reconstr Surg. 2000;  106 1461-1465
• 21 Birch R. Surgery for brachial plexus injuries.  J Bone Joint Surg Br. 1993;  75 346-348
• 22 Gilbert A. Long-term evaluation of brachial plexus surgery in obstetrical palsy.  Hand Clin. 1995;  11 583-595
• 23 Gilbert A, Hentz V R, Tassin J L. Brachial plexus reconstruction in obstetrical palsy: operative indications and postoperative results. In: Urbaniak JR Microsurgery for Major Limb Reconstruction. St. Louis; CV Mosby 1987: 348-364
• 24 Hentz V R. Operative repair of the brachial plexus in infants and children. In: Gelbermann RH Operative Nerve Repair and Reconstruction. Philadelphia; JB Lippincott 1991: 1369-1383
• 25 Piatt J H. Neurosurgical management of birth injuries of the brachial plexus.  Neurosurg Clin N Am. 1991;  2 175-185
• 26 Shenaq S M, Berzine E, Lee R, Laurent J P, Nath R, Nelson M R. Brachial plexus birth injuries and current management.  Clin Plast Surg. 1998;  5 527-536
• 27 Shenaq S M, Dinh T A. Pediatric microsurgery: replantation, revascularization, and obstetric brachial plexus palsy.  Clin Plast Surg. 1990;  17 77-83
• 28 Gilbert A, Tassin J L. Obstetrical palsy: a clinical, pathologic, and surgical review. In: Terzis JK Microreconstruction of Nerve Injuries. Philadelphia; WB Saunders 1987
• 29 Mallet J. Paralysie obstétricale du plexus brachial. Traitement des séquelles. Primaute du traitement de l’épaule-méthode d’expression des résultats.  Rev Chir Orthop Reparatrice Appar Mot. 1972;  58S 166-168
• 30 Daltroy L H, Liang M H, Fossel A H, Goldberg M J. The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America.  J Pediatr Orthop. 1998;  18A 561-571
• 31 Pediatric Outcomes Instrument Development Group .MODEMS Pediatric Outcomes Instrument. Rosemont, IL; American Academy of Orthopaedic Surgeons 1998
• 32 Bae D S, Waters P M, Zurakowski D. Reliability of three classification systems measuring active motion in brachial plexus birth palsy.  J Bone Joint Surg Am. 2003;  85 1733-1738
• 33 Hoffer M M, Wickenden R, Roper B. Brachial plexus birth palsies: results of tendon transfers to the rotator cuff.  J Bone Joint Surg Am. 1978;  60 691-695
• 34 Pearl M L, Edgerton B W. Glenoid deformity secondary to brachial plexus birth palsy.  J Bone Joint Surg Am. 1998;  80 659-667
• 35 Waters P M, Peljovich A E. Shoulder reconstruction in patients with chronic brachial plexus birth palsy.  Clin Orthop. 1999;  364 144-152
• 36 Waters P M, Smith G R, Jaramillo D. Glenohumeral deformity secondary to brachial plexus birth palsy.  J Bone Joint Surg Am. 1998;  80 668-677
• 37 Al-Qattan M M. Rotation osteotomy of the humerus for Erb's palsy in children with humeral head deformity.  J Hand Surg. 2002;  27 479-483
• 38 Goddard N J, Fixsen J A. Rotation osteotomy of the humerus for birth injuries of the brachial plexus.  J Bone Joint Surg Br. 1984;  66 257-259
• 39 Kirkos J M, Papadopoulos I A. Late treatment of brachial plexus palsy secondary to birth injuries: rotational osteotomy of the proximal part of the humerus.  J Bone Joint Surg Am. 1998;  80 1477-1483
• 40 Pondaag W, Malessy M JA, van Dijk J G, Thomeer R TWM. Natural history of obstetric brachial plexus palsy: a systematic review.  Dev Med Child Neurol. 2004;  46 138-144
• 41 Piantadosi S. Clinical Trials. A Methodologic Perspective. New York; John Wiley & Sons 1997: 1148-1168
• 42 Beischer A D, Simmons T D, Torode I P. Glenoid version in children with obstetric brachial plexus palsy.  J Pediatr Orthop. 1999;  19A 359-361
• 43 Gudinchet F, Maeder P, Oberson J C, Schnyder P. Magnetic resonance imaging of the shoulder in children with brachial plexus birth palsy.  Pediatr Radiol. 1995;  25(suppl 1) S125-S128
• 44 Van der Sluijs J A, Van Ouwerkerk W J, De Gast A, Wuisman P, Nollet F, Manoliu R A. Retroversion of the humeral head in children with an obstetric brachial plexus lesion.  J Bone Joint Surg Br. 2002;  84 583-587