The results of a long-term study focusing on the outcome of infants

that suffered a brachial plexus injury (bpi) or erbs palsy at birth

were published in the January 2007 issue of The Journal of Bone and

Joint Surgery.



The study followed up on children that underwent surgery for a bpi

(mean of 13.3 years after surgery).  The researchers studied 1706

children with brachial plexus injuries sustained at birth that

required medical intervention between 1971 and 1997. Of these

patients, 124 (7.3%) underwent surgery on the brachial plexus at a

mean age of 2.8 months (range, 0.4 to 13.2 months). The most commonly

performed surgical procedure was direct neurorrhaphy after neuroma

resection.



The researchers found that approximately one-third of the patients,

including all nine with a clavicular nonunion from the surgical

approach, experienced pain in the affected limb. Additionally, all

except for four patients used the hand of the unaffected arm as the

dominant hand. Shoulder function was moderate, with a mean Mallet

score of  3.0. Both elbow and hand function were good, with a mean

score on the Gilbert elbow scale of 3 and a mean Raimondi hand score

of 4. Incongruence of the glenohumeral joint was noted in sixteen

(16%) of the ninety-nine patients in whom it was assessed, and

incongruence of the radiohumeral joint was noted in twenty-one (21%).

The extent of the brachial plexus injury was found to be strongly

associated with the final shoulder, elbow, and hand function in a

multivariate analysis.



Furthermore, a significant number of the patients continued to need

help performing activities of daily living and had pain in the

affected arm, with the pain due to a clavicular nonunion in one-

fourth of the patients.



As a side note, I want to say that although this study appears to be

harsh, erb's palsy can present in wide spectrum of severity.  That

being said, these results seemed to me, to be preformed on the more

severe cases of erb's palsy.  Finally, the most determinant

prognostic factor predicting the outcome of children affected by a

bpi appears to be the extent of the primary injury.

--- In Erbs_Palsy_Support@yahoogroups.com, "robert_diorio_esq"

<robert_diorio_esq@...> wrote:

>I aree the results are diffrent for everyone. My daughter who is now

five years okld had the surgery done she could not bring her arm to

feed herslef.  The surgery was done at 18 months; we went thur

therapy afterwars and she began using it to feed her slef still

prefers to use the left hand more but will use both hands to perform

things.  Still has diffiulty with somethings but is veryself

sufficient with dressingand all.



> The results of a long-term study focusing on the outcome of infants

> that suffered a brachial plexus injury (bpi) or erbs palsy at birth

> were published in the January 2007 issue of The Journal of Bone and

> Joint Surgery.

>

> The study followed up on children that underwent surgery for a bpi

> (mean of 13.3 years after surgery).  The researchers studied 1706

> children with brachial plexus injuries sustained at birth that

> required medical intervention between 1971 and 1997. Of these

> patients, 124 (7.3%) underwent surgery on the brachial plexus at a

> mean age of 2.8 months (range, 0.4 to 13.2 months). The most

commonly

> performed surgical procedure was direct neurorrhaphy after neuroma

> resection.

>

> The researchers found that approximately one-third of the patients,

> including all nine with a clavicular nonunion from the surgical

> approach, experienced pain in the affected limb. Additionally, all

> except for four patients used the hand of the unaffected arm as the

> dominant hand. Shoulder function was moderate, with a mean Mallet

> score of  3.0. Both elbow and hand function were good, with a mean

> score on the Gilbert elbow scale of 3 and a mean Raimondi hand

score

> of 4. Incongruence of the glenohumeral joint was noted in sixteen

> (16%) of the ninety-nine patients in whom it was assessed, and

> incongruence of the radiohumeral joint was noted in twenty-one

(21%).

> The extent of the brachial plexus injury was found to be strongly

> associated with the final shoulder, elbow, and hand function in a

> multivariate analysis.

>

> Furthermore, a significant number of the patients continued to need

> help performing activities of daily living and had pain in the

> affected arm, with the pain due to a clavicular nonunion in one-

> fourth of the patients.

>

> As a side note, I want to say that although this study appears to

be

> harsh, erb's palsy can present in wide spectrum of severity.  That

> being said, these results seemed to me, to be preformed on the more

> severe cases of erb's palsy.  Finally, the most determinant

> prognostic factor predicting the outcome of children affected by a

> bpi appears to be the extent of the primary injury.

>