Spontaneous recovery of shoulder abduction in obstetric brachial plexus injury patients with less than horizontal abduction at 3 months

This is the authors' abstract. We don't add key points for this paper.

Abduction is one of the important shoulder functions that may be limited after an obstetric brachial plexus injury. We investigated the progress of spontaneous recovery of active abduction in a cohort of 68 conservatively treated obstetric brachial plexus injury patients without full recovery and with less than 90° abduction at 3 months. Of these 65 (96%) recovered at least 90° and 32 (47%) a full 170° of abduction. The median age of recovery to 90° was 9 months (IQR 7–12, range 5–65 and to 170° 24 months (IQR 12–36, range 5–84). The presence of active antigravity elbow flexion ≥90° at 4 months was not associated with recovery of abduction. The results suggest that most obstetric brachial plexus injury patients with isolated absent or slowly recovering shoulder movements recover at least 90° of abduction. In patients with absent or weak abduction, and otherwise satisfactory spontaneous recovery, surgical interventions should not be considered before 1 year of age. Level of evidence: III

Supports continued conservative management for delayed shoulder abduction in obstetric brachial plexus injury; leaves open the optimal timing for.