Brachial Plexus Birth Injury: Treatment and Interventions.

IF 0.7 4区 医学 Q4 SURGERY Plastic surgery Pub Date : 2025-01-12 DOI:10.1177/22925503241301719
Grace O'Shea, Sonia S Patel, Brian A Mailey
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Abstract

Introduction: Brachial plexus birth injury (BPBI) is a condition affecting newborns and involves damage to the nerve fibers compromising the brachial plexus during birth. Although most newborns recover spontaneously, a large subset require surgery to regain function, and others will have permanent disability despite intervention. Deciding when to pursue surgical intervention remains a challenge for clinicians treating BPBI. Methods: A comprehensive search of the literature was conducted using PubMed, Scopus, and MEDLINE databases. A total of 24 primary and secondary sources were chosen for inclusion following full-text assessments. All sources were analyzed to provide a comprehensive review on the development of BPBI treatments and interventions over time. Results: Spontaneous recovery can be achieved in many cases of BPBI, but most patients require physical therapy and other forms of treatment to avoid muscle imbalance and prevent contracture formation. In addition to physical therapy, the most common non-surgical interventions include botulinum toxin injections and splinting. In cases requiring surgery, clinicians may use several tests and diagnostic imaging to aid in decision making. Common surgical interventions for BPBI include nerve grafting, nerve transfers, and muscle and tendon transfers. Conclusion: Most newborns recover from BPBI within the first 3 months of life. However, some require treatment to restore optimal function. In general, non-surgical interventions should be the primary course of treatment, and surgery should be avoided unless the patient is deemed unable to recover with any other treatment.

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臂丛出生损伤:治疗和干预。
臂丛出生损伤(Brachial plexus birth injury, BPBI)是一种影响新生儿的疾病,涉及出生时臂丛神经纤维受损。虽然大多数新生儿会自发康复,但仍有很大一部分需要手术来恢复功能,还有一些即使经过干预也会永久残疾。对于治疗BPBI的临床医生来说,决定何时进行手术干预仍然是一个挑战。方法:采用PubMed、Scopus和MEDLINE数据库进行文献检索。在全文评估后,共选择了24个主要和次要来源纳入。对所有来源进行分析,以全面回顾BPBI治疗和干预措施的发展。结果:许多BPBI病例可以实现自发恢复,但大多数患者需要物理治疗和其他形式的治疗,以避免肌肉失衡和防止挛缩形成。除了物理治疗,最常见的非手术干预包括注射肉毒杆菌毒素和夹板。在需要手术的情况下,临床医生可能会使用几种测试和诊断成像来帮助决策。常见的BPBI手术干预包括神经移植、神经转移、肌肉和肌腱转移。结论:大多数新生儿在出生后3个月内从BPBI中恢复。然而,有些需要治疗才能恢复最佳功能。一般来说,非手术干预应作为治疗的主要方法,除非认为患者无法通过其他治疗恢复,否则应避免手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Plastic surgery
Plastic surgery Medicine-Surgery
CiteScore
1.70
自引率
0.00%
发文量
73
期刊介绍: Plastic Surgery (Chirurgie Plastique) is the official journal of the Canadian Society of Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery, Group for the Advancement of Microsurgery, and the Canadian Society for Surgery of the Hand. It serves as a major venue for Canadian research, society guidelines, and continuing medical education.
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