Acta Scientific Orthopaedics (ASOR)(ISSN: 2581-8635)

Research Article Volume 4 Issue 9

Role of Neurophysiological Studies in Prediction of Prognosis of Obstetrical Brachial Plexus Palsy OBPP

Mohammed Elkhatim, Musaab Mohamed Abdalla* and Elhadi Abdelrahim

Assistant Professor, Karary University, Omdurman, Sudan

*Corresponding Author: Musaab Mohamed Abdalla, Assistant Professor, Karary University, Omdurman, Sudan.

Received: June 29, 2021; Published: August 12, 2021

Abstract

Background: Obstetric brachial Plexus Palsy (OBPP) almost always involves traction of the C5 and C6; nerve roots Resulting in weakness of shoulder function and elbow flexion. Additional involvement of C7, C8 and T1 roots affects elbow extension wrist and hand function. lifelong functional impairment occur in20 to 30% of cases. Mild lesion cannot be distinguished reliably from severe lesions in the prenatal period: only time reveals Whether or not spontaneous recovery will occur. Early identification of severe cases facilitates early referral to specialized centres. where the need for reconstructive nerve surgery can be assessed. Neurophysiologic studies are useful tools for early prognostic assessment of OBPPs. This research will give us data about the role of neurophysiologic studies in prediction of mode of treatment of OBPPs.

Patients and Methods: Case series descriptive retrospective study done in patients with (OBPP) presented to Pediatric Orthopedics Department at Soba University Hospital and underwent surgical correction during the period between (January 2013 and December 2014) and have pre-operative neurophysiologic studies.

Results: In this study we assessed 28 child with obstetrical brachial plexus palsy operated At pediatric orthopedic department, Soba University Hospital from January 2013 to December 2014 twelve male (42.9%) and 16 female (57.1%). Three (10.7%) were below 1 year of age, 20 (71.4%) were between (1 - 10 years). 5 (17.9%) were more than 10 years. Seventeenth (60.7%) with right shoulder affected and 11 children (39.3%) with left shoulder affected. One Child weight less than 2.5 kg (3.6%) while 7 child 25% fell between 2.5 and 4kg, and 20 (71.4%) children were above 4 kg. 4 (14.3%) children had neurophysiologic studies performed before 3 months of age, while the remaining children were all had the neurophysiologic studies after three months of age. The neurophysiologic studies finding showed neuropraxia in 7 (25.0%), axonotmesis in 14 (50.0%) and neurotmesis in 7 (25.0%).

Conclusion: In conclusion, we observed that none of our patients had electromyogram done before surgery. While it is recommended to be done at 1 month as the best time to give accurate prediction of future prognosis. when done within 48 hours following birth it helps to discover the etiology, and it has important medico legal implications. We also found that it is not helpful to rely on the neurophysiological

studies alone in prediction of mode of treatment of OBPP.

Keywords: Obstetric brachial Plexus Palsy (OBPP); C5 and C6 Nerve Roots; Neurophysiological Studies

References

  1. Clark LP., et al. “A study on brachial birth palsy”. The American Journal of the Medical Sciences 130 (1905): 670-705.
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  3. Metaizeau JP., et al. “Brachial plexus birth injuries. An experimental study”. Chir Pediatr 3 (1979): 159-163.
  4. Bager B. “Perinatally acquired brachial plexus palsy–a persisting challenge”. Acta Paediatr 11 (1997): 1214-1219.
  5. Dawodu A., et al. “Risk factors and prognosis for brachial plexus injury and clavicular fracture in neonates: a prospective analysis from the United Arab Emirates”. The Annals of Tropical Paediatrics3 (1997): 195-200.
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Citation

Citation: Musaab Mohamed Abdalla., et al. “Role of Neurophysiological Studies in Prediction of Prognosis of Obstetrical Brachial Plexus Palsy OBPP". Acta Scientific Orthopaedics 4.8 (2021):.

Copyright

Copyright: © 2021 Musaab Mohamed Abdalla., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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