Evaluation and Management of Obstetrical Brachial Palsy

Attitudes regarding surgical reconstruction of the brachial plexus have advanced with the evolution of microsurgical techniques not only in adults but also in infants with obstetrical plexus palsy. Recommendations regarding intervention range from the very conservative and nihilistic to the aggressive and unrealistic. Unfortunately, variations in the methodology and outcomes in reported clinical series have made results difficult to interpret. This article reviews the current attitudes regarding both the conservative and aggressive approaches to the management of obstetrical brachial plexus palsy and offers an algorithm for the appropriate management of these injured infants.