Why the study?
Do early clinical factors like elbow flexion recovery and birthweight predict the final outcome in obstetrical brachial plexus palsy?
Do early clinical factors like elbow flexion recovery and birthweight predict the final outcome in obstetrical brachial plexus palsy?
A combination of initial C7 involvement, increased birthweight, and poor elbow flexion at 6-9 months can predict poor outcomes in obstetrical brachial plexus palsy, potentially justifying early reconstruction.
Elbow flexion recovery at 9 months plus birthweight supports prognostication in obstetrical brachial plexus palsy; leaves open prospective validation before guiding decisions.
Thirty obstetrical brachial plexus palsies involving the upper roots were retrospectively reviewed. There were 20 C5-C6 palsies and ten C5-C6-C7 palsies in which recovery of C7 occurred by the end of the first month. Recovery of elbow flexion at 3 months, C7 involvement and high birthweight were the best early predictors of outcome, but all were unreliable when used separately. In combination, recovery of elbow flexion and birthweight predicted the final outcome reasonably satisfactorily, particularly when elbow flexion at 9 months, and not 3 months was considered (risk of error = 13%). Brachial plexus reconstruction may therefore be justified when there was initial C7 involvement associated with increased birthweight and poor elbow flexion at 6-9 months.
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Nehme et al. (2002) studied this question.
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