[Treatment of early and late obstetric brachial plexus palsy].

The aim of this study was to review and to analyze treatment patterns of early and late obstetric brachial plexus palsy. Eighty-one children with early and late obstetric brachial plexus palsy were treated in the Department of Pediatric Orthopedics and in the Postintensive Care Unit within the period 1988-2002. Children were classified into 2 groups according to age: Ist group (67 newborns) was treated conservatively, and IInd group (14 children with late obstetric brachial plexus palsy with deformity) underwent operative treatment. Active hand movements and innervation were evaluated before and after treatment. Thirty newborns had full recovery, 32 newborns had incomplete recovery, and in 5 cases no improvement was seen. Fourteen children with late obstetric brachial plexus palsy underwent the following operations: rotation osteotomy of the humerus was performed in 10 cases, lengthening of biceps and brachialis muscle tendons--in 6 cases, transposition of triceps muscle tendon--in 1 case, transposition of pectoralis major tendon--in 3 cases and flexor carpi transposition--in 1 case. There was an improvement in active hand movements after operative treatment and rehabilitation. According to our experience, in most cases newborns recover spontaneously or after conservative treatment. Secondary reconstructive surgery of late brachial plexus palsy can improve the condition of these patients.