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OBSTETRIC BRACHIAL PLEXUS PALSY (Erb's Plasy)


Big babies (Birth wt. > 3.5 kg) may get their shoulder stuck while being delivered through a narrow birth passage of mother. While delivering such babies forcibly out of womb, there is a possibility that nerves behind the collar bone can get stretched. Patient may not move the extremity at birth due to inflammation over nerves (neuropraxia). As the edema resolves gradually over 3 – 6 months, child resumes the movement. This recovery is usually from far to near direction. Most of the patients with Brachial Plexus Palsy recovers completely (80%). Some unfortunate patients who have their nerves torn partially or completely (‘axontmesis’ or ‘neurotmesis’) may fail to recover completely. These patients will require a plastic neural reconstruction or salvage procedures.
At OrthoKids Clinic, we run a Comprehensive Brachial Plexus Clinic. A group of Pediatric Orthopedic Surgeon, Plastic Surgeon, Physiotherapist & Occupational therapist examine the patient as a team & make decisions collectively for the well being of the child.

Case1

This 10 year old boy was affected from Brachial Plexus Birth Palsy. Due to residual neural deficit, his arm could not be rotated outwards. Due to internal rotation contracture at shoulder, he required to lift his arm at almost 180 degrees for hand-to-mouth movement.

Dr.Maulin Shah performed soft tissue release & transferred tendon to the outer aspect of arm bone. Two months after surgery, this young boy is happy to rotate his arm outward completely & now he can eat food with right hand without lifting his extremity. He was happy about not disturbing person sitting besides him on dinning table.

Case2

Parents brought Sahil to Dr.Shah at the age of 16 months. He suffered from Obstetric Brachial Plexus Palsy. Parents were concerned about his inability to lift arm beyond 60 degrees.

Three months after the first meeting with Dr. Shah, Sahil could do almost all over head activities. Dr. Maulin Shah performed a soft tissue release & tendon transfer surgery. At other centres, Parents were advised to wait till 4 years of age for the similar surgery. Parents are happy about their decision of consenting early surgery at Orthokids Clinic.

Case3

A.B was a 1.2 Year old girl with restricted shoulder (arm) Elevaction she was treated with botox therapy & her over head activities improved

Case4

D.S was a 10 years old girl with residual erb’s palsy.she improved after refalancing surgery.