Primary Repair of Total Obstetrical Brachial Plexus Palsy

Up to the present time, the standard treatment of high traction lesions of the brachial plexus is by grafting nerves ruptured outside the spinal canal & by neurotization to the distal segments of avulsed nerve roots. The goal of many of those working in this field has for long been the reimplantation of avulsed nerve roots into the spinal cord .The majority of patients who suffer from obstetrical brachial plexus palsy will make a spontaneous recovery and nonoperative management will yield the best functional outcome in most injured infants. A minority of the injured infants, however, is not destined to have any meaningful recovery and will suffer from a lifelong disability if no intervention is undertaken. If these infants who are destined for a poor recovery can be identified early and followed by a team approach, decisions regarding surgical intervention can be made at an early age, when the chance of a successful surgical outcome is highest. Early surgical reconstruction of the brachial plexus has been shown to improve functional outcome to a reasonable level.