Find best premium and Free Joomla templates at GetJoomlaTemplatesFree.com

Obstetrical brachial plexus paralysis: report of 35 cases

FF. Mouafo Tambo, OG. Andzé

Department of Pediatric Surgery, Gynaeco - Obstetrics and Pediatric Hospital (HGOPY), Yaounde, Cameroun

 

ABSTRACT

Introduction: The obstetrical paralysis of the brachial plexus is the result of the brachial plexus trauma occurring during dystocic childbirth in the majority of the cases. The goal of this work was to report our experience and to find an epidemiological profile that could lead to prevention.

Material and methods: Our study is retrospective, reporting 35 cases of children admitted in the department of pediatric surgery of the HGOPY for obstetrical trauma of the upper limb associated with functional impotence, from January 2004 to July 2007, meaning 3 years and half. The collected data concerned: age, sex, side, birth weight, risk factors, electromyographic study, treatment and evolution.

Result: The age at the 1st consultation varied between 2 days and 8 months and only 14, 28% of the patients were consulted during the first week of life. More frequently were involved girls, the right side and high birth-weight babies. The risk factors were dominated by the dystocic childbirth with 88, 57% of the cases. The absence of the electromyographic study was remarkable. The treatment was palliative, functional, electric and orthopedic. The evolution was variable with 17% lost to follow-up, 57% sequelae and 26% total recovery at 6 months. discussion: The absence of electromyographic study doesn’t allow to make a lesion diagnostic, neither to have an efficient surveillance. The microsurgery and the transplantation surgery cannot be performed technically in our environment, so that we must focus on the prevention.

Conclusion: The therapeutic management difficulties for patients with obstetrical brachial plexus paralysis, in our context force us to strengthen prevention and also to have a multidisciplinary approach where the physiotherapist has an important place.

 

Key words: obstetrical paralysis of the brachial plexus, newborn, physiotherapy.