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Journal of Hand Surgery (British and European Volume)
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Obstetrical Brachial Plexus Palsy. Prediction of Outcome in Upper Root Injuries

A. NEHME
J. KANY
J. SALES-DE-GAUZY
J. P. CHARLET
G. DAUTEL
J. P. CAHUZAC

From the Department of Paediatric Orthopaedic Surgery, Hospital des Enfants, the Department of Plastic and Reconstructive Surgery of Locomotion Apparatus, Hospital Jeanne D’Arc, and the Department of Epidemiology, Toulouse, France

Correspondence: Dr. Alexander Nehme, Department of Orthopaedic Surgery, Centre Hospitalier de Toulouse Rangueil 1, Avenue Jean Poulhes, 31059 Toulouse Cedex, France. E-mail: inehme{at}club-internet.fr

Thirty obstetrical brachial plexus palsies involving the upper roots were retrospectively reviewed. There were 20 C5–C6 palsies and ten C5–C6–C7 palsies in which recovery of C7 occured by the end of the first month. Recovery of elbow flexion at 3 months, C7 involvement and high birthweight were the best early predictors of outcome, but all were unreliable when used separately. In combination, recovery of elbow flexion and birthweight predicted the final outcome reasonably satisfactorily, particularly when elbow flexion at 9 months, and not 3 months was considered (risk of error = 13%). Brachial plexus reconstruction may therefore be justified when there was initial C7 involvement associated with increased birthweight and poor elbow flexion at 6–9 months.

Journal of Hand Surgery (British and European Volume), Vol. 27, No. 1, 9-12 (2002)
DOI: 10.1054/JHSB.2001.0655
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