Key result
Co-contraction in patients with obstetric brachial plexus palsy is caused by aberrant reinnervation and central motor programming disorders, and can be treated with botulinum toxin A or surgery.
This review highlights that co-contraction in obstetric palsy stems from aberrant nerve regeneration and central motor programming issues, and outlines modern treatments including botulinum toxin A and surgery.
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Should not yet change practice in obstetric brachial plexus palsy; leaves open need for prospective trials on botulinum toxin A and surgery.
The frequency of obstetric palsy ranges from 0.5 to 3.0 cases per 1000 live births. The functional outcome disorders are determined by the nature of the damage and the number of damaged roots of the brachial plexus. There are 50 % of patients have complete recovery, 15 % have severe functional disorders of the upper limb, and 35 % have some limitation of the shoulder joint function. There are 3 variants of residual phenomena in children with obstetric palsy: paresis, paralysis, and co‑contraction. The article describes the mechanisms of nerve regeneration in children and adults, the pathogenesis of contractions and motor disorders in general in children with obstetric palsy, and modern methods of treatment of co‑contraction. This article will be useful for neurologists, rehabilitation specialists, and orthopedists.
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Olga Е. Agranovich (2021) conducted a review in Obstetric brachial plexus palsy (co-contraction). Botulinum toxin A and surgical interventions was evaluated. Co-contraction in patients with obstetric brachial plexus palsy is caused by aberrant reinnervation and central motor programming disorders, and can be treated with botulinum toxin A or surgery.
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