Neonatal Brachial Plexus Palsy

Mehlman, Charles T.

doi:10.1007/978-1-4614-8515-5_27

Cited by 3 publications

(5 citation statements)

References 80 publications

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“…Polydactyly in the preaxial axis Preaxial polydactyly (PPD) is less prevalent than PAP, with a frequency of 0.08% to 1.4% per 1000 live births. [30] In PPD, a wide range of duplications may be seen, from a normal thumb to an entirely duplicated ray. To varying degrees, tendons, bones, ligaments, and blood vessels are abnormally formed in the hands of people who have had their thumbs duplicated.…”

Section: Type Of Mutationmentioning

confidence: 99%

A review of polydactyly and its inheritance: Connecting the dots

Bubshait

2022

Medicine

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Objective: This study collects what is known about the inheritance underpinnings of syndromic and non-syndromic polydactylies and highlights dactyly presentations with unknown genetic roots. This review summarizes the current information and geneticsenhanced understanding of polydactyly.Background: There is a frequency of 0.37 to 1.2 per 1000 live births for polydactyly, which is also known as hyperdactyly. It is characterized by the presence of extra fingers. Polydactyly is caused by a failure in limb development, specifically the patterning of the developing limb bud. The phenotypic and genetic variability of polydactyly makes its etiology difficult to understand. Preaxial polydactyly, central polydactyly (axial), and postaxial polydactyly are all examples of non-syndromic polydactyly (ulnar). An autosomal dominant disorder with varying penetrance that is mostly passed down via limb development patterning abnormalities.Method: A comprehensive search of MEDLINE/PubMed and other databases was followed by an evaluation of the relevant papers, with a particular focus on those published between 2000 and 2022.Results: Of 747 published article related to Polydactyly from MEDLINE/PubMed search, 43 were from the last 10 years and were the focus of this review. Conclusion:Polydactyly is one of the most frequent congenital hand malformations. PAP is more common than PPD, whereas central polydactyly is very uncommon.

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Section: Type Of Mutationmentioning

confidence: 99%

A review of polydactyly and its inheritance: Connecting the dots

Bubshait

2022

Medicine

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“…The reported incidence of neonatal brachial plexus palsy (NBPP) continues to be 1.5 per 1000 live births despite significant technological advancement in the field of obstetrics [1]. NBPP results from over-stretching of the neonatal brachial plexus during complicated birthing scenarios, such as shoulder dystocia, and can significantly impact the infants' quality of life [2][3][4][5][6][7][8][9]. The current standard of care allows proper diagnosis only after the first two-three months of birth and while 70-90% of affected infants recover spontaneously, 20-30% of affected infants do suffer permanent deficits such as decreased strength, size, and girth of affected muscles, and limited range of motion [5,8,10].…”

Section: Introductionmentioning

confidence: 99%

“…NBPP results from over-stretching of the neonatal brachial plexus during complicated birthing scenarios, such as shoulder dystocia, and can significantly impact the infants' quality of life [2][3][4][5][6][7][8][9]. The current standard of care allows proper diagnosis only after the first two-three months of birth and while 70-90% of affected infants recover spontaneously, 20-30% of affected infants do suffer permanent deficits such as decreased strength, size, and girth of affected muscles, and limited range of motion [5,8,10]. The delay of NBPP prognosis is inevitable due to the age of the infants, however, an understanding of the injury severity in these neonates can help predict the injury outcome.…”

Section: Introductionmentioning

confidence: 99%

In vivo biomechanical responses of neonatal brachial plexus when subjected to stretch

Singh,

Orozco,

Balasubramanian

2023

PLoS ONE

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Neonatal brachial plexus palsy (NBPP) results from over-stretching of the neonatal brachial plexus during complicated birthing scenarios. The lack of information on the biomechanical response of the neonatal brachial plexus complex when subjected to stretch limits our understanding of the NBPP injury mechanism. This study aims to fill that critical gap by using a neonatal piglet animal model and providing the in vivo biomechanical properties of the neonatal brachial plexus complex when subjected to stretch. Forty-seven brachial plexus levels (identified by the four brachial plexus terminal nerve branches namely musculocutaneous, median, ulnar, and radial), obtained from 16 neonatal Yorkshire piglets (3–5 days old), were subjected to stretch-induced failure. The average maximum load and corresponding strain were reported to be 16.6 ± 1.3 N and 36.1 ± 1.6%, respectively. Maximum loads reported at the musculocutaneous level were significantly lower than the median and radial levels. No differences in strains at failure were reported at all four tested levels. Proximal or distal failure locations were reported in 83% of the tests with 17% mid-length ruptures that were primarily reported at the bifurcation of the median and ulnar brachial plexus levels. Histological studies reported an overall loss of wavy pattern of the nerve fibers, an increase in nerve spacing, fiber disruptions, and blood vessel ruptures in the stretched tissue. This in vivo piglet animal study offers insight into the NBPP mechanism by reporting biomechanical, injury location, and structural damage responses in neonatal brachial plexus when subjected to stretch.

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“…Neonatal brachial plexus palsy (NBPP) continues to significantly impact infants' lives, with a worldwide incidence of 1 to 4 per 1000 live births, despite improvements in obstetric care [1][2][3][4][5][6]. NBPP occurs due to overstretching of the brachial plexus during birth, either by clinician applied (exogenous) or maternal (endogenous) forces [1,5,6]. Shoulder dystocia, a birthing scenario where the fetal shoulder/s impacts against the mother's pubic symphysis, is strongly associated with NBPP [1][2][3]5].…”

Section: Introductionmentioning

confidence: 99%

“…While 70-90% of NBPP cases have reported spontaneous recovery in the first three months of an infant's life, 20-30% of the affected infants do not experience substantial spontaneous recovery, even by the third month [1,7,8]. Such cases result in a permanently reduced range of motion and a decrease in strength, size, and girth of the affected muscles [6,9,10]. A recent publication showed that the reported incidence of spontaneous recovery from NBPP is less than what has been previously hypothesized, thereby increasing the need for improved diagnostic tools [11].…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of the Electrodiagnostic Assessment of Neonatal Brachial Plexus Palsy

Singh

Balasubramanian

Orozco

2020

NNB

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Despite improvements in obstetric care, neonatal brachial plexus palsy continues to significantly impact infants’ lives worldwide, with an incidence of 1 to 4 per 1000 live births. While a majority of affected infants recover spontaneously by three months, 20-30% suffer permanent functional deficits that significantly impair their quality of life. Anatomical complexity of the brachial plexus results in varying degrees of injury and pathological changes at multiple levels within the plexus. Current clinical diagnosis relies on electrodiagnostic techniques such as nerve conduction (i.e., motor and sensory) and electromyography studies. These techniques not only aid clinicians to differentiate between axonal and demyelinating lesions, evident by changes in signal shape and conduction, but also provide prognostic information in cases of brachial plexus injuries. The presented study offers a comprehensive review of existing literature on electrodiagnostic techniques employed for assessing neonatal brachial plexus injuries.

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Neonatal Brachial Plexus Palsy

Cited by 3 publications

References 80 publications

A review of polydactyly and its inheritance: Connecting the dots

A review of polydactyly and its inheritance: Connecting the dots

In vivo biomechanical responses of neonatal brachial plexus when subjected to stretch

A Systematic Review of the Electrodiagnostic Assessment of Neonatal Brachial Plexus Palsy

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