The Prognostic Value of Concurrent Horner Syndrome in Extended Erb Obstetric Brachial Plexus Palsy

El-Sayed, Amel A. F.

doi:10.1177/0883073813516195

Cited by 11 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, Waters demonstrated that if biceps function has not returned by 3 months, the patient will rarely have complete recovery and will likely have decreased shoulder strength and range of motion [14]. Phrenic nerve injury (resulting in paralysis of the hemidiaphragm) and Horner's syndrome are individually considered prognostic for poor motor recovery and are associated with nerve root avulsion [15,16]. Paralysis of the hemidiaphragm can be diagnosed with plain radiography or ultrasonography.…”

Section: Natural Historymentioning

confidence: 99%

The natural history and management of brachial plexus birth palsy

Buterbaugh

Shah

2016

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Brachial plexus birth palsy (BPBP) is an upper extremity paralysis that occurs due to traction injury of the brachial plexus during childbirth. Approximately 20 % of children with brachial plexus birth palsy will have residual neurologic deficits. These permanent and significant impacts on upper limb function continue to spur interest in optimizing the management of a problem with a highly variable natural history. BPBP is generally diagnosed on clinical examination and does not typically require cross-sectional imaging. Physical examination is also the best modality to determine candidates for microsurgical reconstruction of the brachial plexus. The key finding on physical examination that determines need for microsurgery is recovery of antigravity elbow flexion by 3-6 months of age. When indicated, both microsurgery and secondary shoulder and elbow procedures are effective and can substantially improve functional outcomes. These procedures include nerve transfers and nerve grafting in infants and secondary procedures in children, such as botulinum toxin injection, shoulder tendon transfers, and humeral derotational osteotomy.

show abstract

Section: Natural Historymentioning

confidence: 99%

The natural history and management of brachial plexus birth palsy

Buterbaugh

Shah

2016

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

“…The surgical literature on OBBP only includes Horner syndrome in a subset of infants with total palsy [ 12 ] and documents the syndrome as a poor prognostic sign for satisfactory motor recovery [ 13 ]. However, the neurology literature documents that the syndrome is not always associated with total palsy, as it is occasionally seen in extended Erb birth palsy [ 14 ]. In fresh cadaveric dissections, the origin of the white rami communicantes of the stellate ganglion is from the C7, C8, and T1 spinal nerves in 87% of infant cadavers and from C8/T1 roots in 100% of adult cadavers [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Scarring of the C8-T1 roots with partial avulsion in situ in total obstetric brachial plexus palsy

Al‐Qattan

El-Sayed

2017

Eur J Plast Surg

Self Cite

View full text Add to dashboard Cite

BackgroundPrimary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach.MethodsA series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots). Management of the injured upper roots was done by neurotization. Recovery was assessed as per our motor grading system.ResultsAfter a minimum follow-up of 4 years, hand functional recovery was considered good in 7 patients and excellent in the remaining 7 patients.ConclusionsWe highlight the scarring of lower roots with evidence of partial avulsion-in situ in obstetric palsy. We also document that neurolysis is an acceptable approach to such lesions.Level of Evidence: Level IV, therapeutic study.

show abstract

“…The timing for surgery in infants with Erb’s palsy may be delayed until 3-12 months of age. 6 - 8 One major problem in the management of OBPI in Saudi Arabia is the delayed referral to the obstetric brachial plexus clinic (personal communication with the director of the first OBPI clinic in Saudi Arabia). 3 One potential reason is the lack of knowledge among the concerned health care providers (obstetricians, pediatricians, and physio-/occupational therapists) in Saudi Arabia.…”

mentioning

confidence: 99%

Obstetric brachial plexus injury

Al-Essa

Al-Khilaiwi²,

Alqahtani³

et al. 2017

SMJ

View full text Add to dashboard Cite

Objectives:To assess the basic knowledge on obstetric brachial plexus injury among obstetricians, pediatricians, and physio-/occupational therapists in major hospitals in Riyadh. We aimed to identify if inadequate knowledge is the reason behind delayed referrals to the Hand Clinic.Methods:This is a cross-sectional questionnaire-based study conducted at 5 major hospitals in Riyadh, Saudi Arabia between June 2015 and August 2015. A questionnaire of 6 questions (multiple choice closed-ended questions) was given to obstetricians, pediatricians, and physio-/occupational therapists’ in these selected hospitals. The total score out of 6 was categorized as good, adequate, and inadequate knowledge if the score is 5-6, 3-4, and less than 3; respectively. The data were analyzed with Chi-square, fisher exact, Analysis of Variance, and Post-hoc tests where appropriate.Results:A total of 323 subjects participated in the study. For positions, the best mean score (for all 6 questions) was scored by consultants and the score was only 2.95 out of 6. For hospitals, Hospital IV scored the best mean score (2.99). The mean scores were not significantly different between different specialties.Conclusion:Inadequate knowledge seems to be a reason for delayed referrals of cases of obstetric brachial plexus injury to Hand Clinics in Riyadh, Saudi Arabia.

show abstract

The Prognostic Value of Concurrent Horner Syndrome in Extended Erb Obstetric Brachial Plexus Palsy

Cited by 11 publications

References 12 publications

The natural history and management of brachial plexus birth palsy

The natural history and management of brachial plexus birth palsy

Scarring of the C8-T1 roots with partial avulsion in situ in total obstetric brachial plexus palsy

Obstetric brachial plexus injury

Contact Info

Product

Resources

About