ABSTRACT
LEVEL OF EVIDENCE: IV.
ABSTRACT
Brachial plexus birth injury is an upper-extremity paralysis that occurs from a traction injury to the brachial plexus during birth. Approximately 10% to 30% of children with a brachial plexus birth injury have residual neurologic deficits with associated impact on upper-limb function. Management of brachial plexus birth injuries with a multidisciplinary team allows optimization of functional recovery while avoiding unnecessary intervention. Early occupational therapy should be initiated with a focus on range of motion and motor learning. The need for microsurgical reconstruction of the brachial plexus can be predicted based on early physical examination findings, and reconstruction is generally performed at 3 to 9 months of age. The majority of children with residual neurologic deficits develop associated glenohumeral dysplasia. These children may require secondary procedures, including botulinum toxin injection, subscapularis and pectoralis lengthening, shoulder capsular release, shoulder tendon transfer, and humeral osteotomy.
Subject(s)
Birth Injuries/therapy , Brachial Plexus Neuropathies/therapy , Patient Care Team , Birth Injuries/diagnostic imaging , Birth Injuries/rehabilitation , Brachial Plexus Neuropathies/diagnostic imaging , Brachial Plexus Neuropathies/rehabilitation , Humans , Infant , Male , Neurologic Examination , Occupational Therapy , Radiography , SurgeonsABSTRACT
PURPOSE OF REVIEW: To provide a current review of the embryology, classification, evaluation, surgical management, and clinical outcomes related to preaxial polydactyly. RECENT FINDINGS: Recent studies include a proposed embryologic link between preaxial polydactyly and other congenital abnormalities, an evaluation of long-term postsurgical outcomes, and an examination of important predictors for postsurgical outcomes. Preaxial polydactyly, while relatively uncommon, is a complex congenital hand abnormality that requires careful preoperative classification and proper surgical intervention timing to yield optimal outcomes.
