Conservative treatment of obstetrical brachial plexus injury : a combined-staged approach versus physiotherapy alone

Abstract EN

Background and Objectives: Brachial plexus injury is caused by forceful traction on brachial plexus during difficult labour.

According to literature, conservative treatment can result in significant improvement in majority of cases.

The objective of this study is to determine the exact stages of nonsurgical management of newborn babies with Obstetrical brachial plexus injury.

Methods: Hundred newborn babies with upper brachial plexus injury were included in the study.

They were classified randomly into two groups.

The first group (50 cases) was received the classical physiotherapy management.

The second group (50 cases) was received combined therapy including splint, electrical stimulation and physiotherapy.

The treatment was continued till the age of 18 months in both groups.

The treatment evaluation was performed by active assessment scale.

Results: The average age of newborn babies at time of presentation was 2 weeks.

90% of the cases were upper brachial plexus injury (44 cases in group one and 46 cases in group two).

There was significant improvement in range of motion in group two comparing to group one.

Moreover, those who received treatment before the age of 6 weeks demonstrated better response to treatment than those received treatment after the age of 6 weeks.

Conclusions: The effect of physiotherapy in obstetrical brachial plexus injury will be more if it is combined with electrical stimulation and limb splintage.

The intervention by conservative treatment should be started as soon as possible after birth because the chance of failure by nonsurgical treatment will increase significantly with increasing age.