UPDATE ON MANAGEM'ENT OF PEDIATRIC BRACHI'AL PLEXUS PALSY

Abstract

Brachial plexus injuries have been documented in the obstetric and midwifery literature since the 1770s. Smilie (1764) was the first to mention paralysis of the arm resulting from injuries to the brachial plexus during delivery. The obstetrical brachial plexus palsy is evident at birth. The level and severity of nerve injury determine the extent of motor and sensory loss. In the whole-arm type, the affected upper limb lies motionless at the side of trunk with the elbow in extension, the wrist in flexion, and the fingers in semiextension. On stimulation, there is no active movement. The grasp, asymmetric, tonic, and Moro reflexes are absent on the involved side.49