Evaluation of shoulder function after secondary surgery in children with Neonatal Brachial Plexus Palsy

2015 ◽  
Vol 8 (3) ◽  
pp. 187-196 ◽  
Author(s):  
Menno van der Holst ◽  
Thea P.M. Vliet Vlieland ◽  
Jorit J.L. Meesters ◽  
W. Peter Bekkering ◽  
Jochem Nagels ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Shoulder Function ◽  
Brachial Plexus Palsy ◽  
Secondary Surgery ◽  
Neonatal Brachial Plexus Palsy

EARLY COMBINED NEUROSURGERY AND ORTHOPAEDIC SURGERY IN NEONATAL BRACHIAL PLEXUS PALSY

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 155-159 ◽  
Author(s):  
Ram Palti ◽  
Maxim D. Horwitz ◽  
Nicholas C. Smith ◽  
Michael A. Tonkin
Keyword(s):  
Brachial Plexus ◽  
Neurological Deficit ◽  
Orthopaedic Surgery ◽  
Shoulder Function ◽  
Brachial Plexus Palsy ◽  
Combined Procedure ◽  
Neonatal Brachial Plexus Palsy ◽  
Nerve Surgery ◽  
Plexus Lesion ◽  
Glenohumeral Dislocation

Three cases are presented in which neurosurgical reconstruction of a Neonatal Brachial Plexus Palsy was combined with orthopaedic reconstruction of a posterior glenohumeral dislocation. The authors believe that a combined procedure is indicated if the neurological deficit meets the criteria for neural reconstruction and the complication of a posterior glenohumeral dislocation has occurred prior to nerve surgery. Two children with C5–6 lesions and a third child with a pan-plexus lesion obtained good shoulder function following the combined reconstruction.

scholarly journals Peripartum and neonatal factors associated with the persistence of neonatal brachial plexus palsy at 1 year: a review of 382 cases

2016 ◽  
Vol 17 (5) ◽  
pp. 618-624 ◽  
Author(s):  
Thomas J. Wilson ◽  
Kate W. C. Chang ◽  
Suneet P. Chauhan ◽  
Lynda J. S. Yang
Keyword(s):  
Brachial Plexus ◽  
Prediction Algorithm ◽  
University Of Michigan ◽  
Brachial Plexus Palsy ◽  
Factors Associated ◽  
Neonatal Brachial Plexus Palsy ◽  
Active Range Of Motion ◽  
Wide Range ◽  
Nerve Surgery ◽  
The University

OBJECTIVE Neonatal brachial plexus palsy (NBPP) occurs due to the stretching of the nerves of the brachial plexus before, during, or after delivery. NBPP can resolve spontaneously or become persistent. To determine if nerve surgery is indicated, predicting recovery is necessary but difficult. Historical attempts explored the association of recovery with only clinical and electrodiagnostic examinations. However, no data exist regarding the neonatal and peripartum factors associated with NBPP persistence. METHODS This retrospective cohort study involved all NBPP patients at the University of Michigan between 2005 and 2015. Peripartum and neonatal factors were assessed for their association with persistent NBPP at 1 year, as defined as the presence of musculoskeletal contractures or an active range of motion that deviated from normal by > 10° (shoulder, elbow, hand, and finger ranges of motion were recorded). Standard statistical methods were used. RESULTS Of 382 children with NBPP, 85% had persistent NBPP at 1 year. A wide range of neonatal and peripartum factors was explored. We found that cephalic presentation, induction or augmentation of labor, birth weight > 9 lbs, and the presence of Horner syndrome all significantly increased the odds of persistence at 1 year, while cesarean delivery and Narakas Grade I to II injury significantly reduced the odds of persistence. CONCLUSIONS Peripartum/neonatal factors were identified that significantly altered the odds of having persistent NBPP at 1 year. Combining these peripartum/neonatal factors with previously published clinical examination findings associated with persistence should allow the development of a prediction algorithm. The implementation of this algorithm may allow the earlier recognition of those cases likely to persist and thus enable earlier intervention, which may improve surgical outcomes.

scholarly journals Medical Decision-Making among Adolescents with Neonatal Brachial Plexus Palsy and Their Families

2013 ◽  
Vol 131 (6) ◽  
pp. 880e-887e ◽  
Author(s):  
Lee Squitieri ◽  
Bradley P. Larson ◽  
Kate W.-C. Chang ◽  
Lynda J.-S. Yang ◽  
Kevin C. Chung
Keyword(s):  
Decision Making ◽  
Brachial Plexus ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Brachial Plexus Palsy ◽  
Neonatal Brachial Plexus Palsy

Neonatal brachial plexus palsy with vaginal birth after cesarean delivery: a case-control study

2013 ◽  
Vol 208 (3) ◽  
pp. 229.e1-229.e5 ◽  
Author(s):  
Ibrahim A. Hammad ◽  
Suneet P. Chauhan ◽  
Robert B. Gherman ◽  
Joseph G. Ouzounian ◽  
James B. Hill ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Cesarean Delivery ◽  
Case Control Study ◽  
Case Control ◽  
Vaginal Birth ◽  
Brachial Plexus Palsy ◽  
Vaginal Birth After Cesarean ◽  
Neonatal Brachial Plexus Palsy ◽  
Control Study

Lack of physician-patient communication as a key factor associated with malpractice litigation in neonatal brachial plexus palsy

2014 ◽  
Vol 13 (2) ◽  
pp. 238-242 ◽  
Author(s):  
Joseph Domino ◽  
Connie McGovern ◽  
Kate W. C. Chang ◽  
Noelle E. Carlozzi ◽  
Lynda J. S. Yang
Keyword(s):  
Brachial Plexus ◽  
Perinatal Period ◽  
Legal Action ◽  
University Of Michigan ◽  
Brachial Plexus Palsy ◽  
Key Factors ◽  
Malpractice Litigation ◽  
Factors Associated ◽  
Neonatal Brachial Plexus Palsy ◽  
The University

Object Perinatal disorders are prone to malpractice litigation. Neonatal brachial plexus palsy (NBPP) results from stretching the nerves in the perinatal period and may lead to paresis or paralysis and sensory loss in the affected arm. Little is known about the key factors associated with malpractice litigation by families of patients with NBPP and whether these factors reflect the practice environment or are inherent to the condition. In this study, the authors documented the percentage of families of NBPP patients at a specialty center that had filed a malpractice suit and described the key factors associated with that pursuit of legal action. Methods The families/caregivers of 51 patients with NBPP who had presented to the University of Michigan Interdisciplinary Brachial Plexus Program participated in this study. A qualitative research design was applied using both a questionnaire to examine psychosocial factors and a dynamic tool to measure health outcomes from the patient perspective via parent proxy (Patient-Reported Outcomes Measurement Information System [PROMIS] assessment instruments). Statistical analysis included the Fisher exact test, chi-square test, and Student t-test. The study protocol was approved by the University of Michigan institutional review board. Results Forty-seven percent of the families pursued malpractice litigation. In comparing patient families that had pursued legal action with those that had not, significant differences were revealed in the perception that the sustained birth injury was unnecessary (p = 0.002), the information received in the perinatal period was inadequate (p = 0.003), family concerns were ignored in the perinatal period (p = 0.005), and family concerns were not adequately addressed (p < 0.001). Sixty-six percent of the families received external advice to pursue legal action. The PROMIS survey revealed significant group differences in depressive symptoms (p = 0.008), fatigue (p = 0.02), pain (p = 0.01), and anger (p = 0.004). In contrast, the extent of NBPP was not associated with malpractice litigation (p = 0.18). Age, sex, and race were not significantly different between litigation and nonlitigation groups. Conclusions Physician-controllable factors, such as communication in the perinatal period, are associated with malpractice litigation in NBPP. The perceived level of global disability may affect the pursuit of malpractice litigation, whereas the isolated extent of nerve root involvement and/or upper extremity dysfunction are not significant factors in pursuing litigation. Identifying and ameliorating these factors within the practice environment may decrease the animosity between families and health care providers and improve overall outcome for patients with NBPP.

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