Obstetrical Brachial Plexus Palsy: The Istanbul Experience

Among various congenital disabilities following birth trauma, brachial plexus palsy has remained one of the most devastating for many years. The debates about physical therapy alone versus surgical intervention, as well as the proper timing for surgery if indicated, are still open. In our institute, brachial plexus palsies with hand involvement and Horner's sign are surgically treated at the third month of age, and infants with insufficient elbow flexion undergo surgery at the fifth month. Although early neural reconstruction decreases the need for future reconstructive surgical procedures, the children can still have upper extremity deformities that may need to be treated by future muscle releases and transfers. We believe that in patients who missed the chance of primary neural reconstruction, satisfying shoulder function can still be achieved by palliative surgery before glenohumeral joint deformity occurs.