Key result
In children with obstetric brachial plexus injury, panplexopathy was associated with a significantly higher rate of muscle atrophy (40% vs 4.8%, p=0.027) and more frequent range of motion limitations compared to those without panplexopathy.
Why the study?
Obstetric brachial plexus injury can cause sequelae despite being preventable, yet cases occur without apparent risk factors and conflicting findings persist regarding the most significant risk factor.
Cohort (n=31)
No
Oxytocin administration is a significant risk factor for obstetric brachial plexus injury, and cases with panplexopathy have a worse prognosis with more frequent range of motion limitations and muscle atrophy.
Panplexopathy signals worse prognosis with more motion restrictions and atrophy after obstetric brachial plexus injury; leaves open oxytocin as risk factor pending prospective data.
Obstetric brachial plexus injury (OBPI) is an important preventable complication of the birth process. While most cases recover in the early period, a substantial number result in sequelae. Despite established risk factors, there are cases that occur without any apparent risk factors. Our study aims to identify prenatal risk factors by examining OBPI cases born in our hospital and to provide insights into the prognosis of the disease by comparing cases with panplexopathy to those without. We included 31 cases followed for OBPI in our hospital. Risk factors related to the infant and the mother were investigated. The range of motion (ROM) measurements of the affected upper extremity joints, muscle strength, atrophy, and scoliosis status were evaluated. Of the cases, 71% were girls, and 61.3% had left-sided involvement. Additionally, 84.1% had risk factors, with oxytocin administration being the most frequently identified risk factor. In our study, we compared cases with panplexopathy to those without. Shoulder abduction, shoulder adduction, wrist flexion, and wrist extension restrictions were significantly more common in cases with panplexopathy. Furthermore, muscle atrophy was significantly more frequent in the panplexopathy group. Since OBPI is a preventable injury, identifying risk factors is crucial. However, there are conflicting results regarding the most significant risk factor. Our study highlights that oxytocin administration is a very important risk factor for OBPI. We found that cases with panplexopathy had a worse prognosis, with more frequent ROM limitations and muscle atrophy.
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Kurt et al. (2024) conducted a cohort in Obstetric Brachial Plexus Injury (OBPI) (n=31). Panplexopathy vs. No panplexopathy was evaluated on Muscle atrophy (p=0.027). In children with obstetric brachial plexus injury, panplexopathy was associated with a significantly higher rate of muscle atrophy (40% vs 4.8%, p=0.027) and more frequent range of motion limitations compared to those without panplexopathy.
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