Orthopaedic considerations in obstetric brachial plexus palsy.

Obstetric brachial plexus palsies are seen in orthopaedic practice today despite improved obstetric care. The incidence is believed to be 0.35 to 0.87 cases per 1,000 live births. The pathomechanics of these injuries are not fully understood, although numerous risk factors have been identified. Large birth weight, breech presentation, shoulder dystocia, and forceps-assisted deliveries have all been implicated. No one standard treatment modality exists. Therefore, the treating orthopaedist must be familiar with this entity and with the various accepted treatment approaches in order to formulate the appropriate therapy for a particular patient.