Brachial Plexus Palsy Flashcards
OBPP
-Birth injury when BP is injured by stretching of neck and arm
-commonly caused by Shoulder dystocia
-Leads weakness or paralysis
Shoulder Dystocia
-baby’s shoulder gets stuck behind the mother’s pubic bone
Goals for Pt w/ BPP
-maintain or improve ROM
-Encourage functional use of UE
-Avoid further injury
-Improve sensory awareness
Interventions for Pt w/ BPP
-ROM
-Strengthening
-functional activites
-educationn
-Neuro estim
-Biofeedback
-splinting
Precautions for BPP
-protocols for activity restriction
-avoid overstretching
-dec sensation
-Biomchanical alignment
Complications for OBPP
-torticollis
-dec sensation
-unbstable joints
-contractures
-falccidity
-neglect UE
-Horner Syndrome
Erb’s Palsy
-most common; upper; C5-C7
-waiter’s tip
-ADD/IR/ext/pronate/finger flexion
Klumpke’s Palsy
-Least common; lower; C7-T1
-intact shoulder and elbow
-paralysis of wrist flexor and extensors, intrinsic hand muscles
-forearm in held supination
Erb-Klumpke Palsy
-C5-T1
-Total arm paralysis
Neuropraxia
-temporary nerve conduction block due to stretch
Complete Avulsion
-nerve root torn away from SC
Risk Factors for OBPP
-inc birth weight
-shoulder dystocia
-maternal diabetes
-difficult labor
-breech
-forcepps assisted
Horner Syndrome
-dec sweating
-abnormal pupillary contraction
-ptosis
Surgical Options
Primary Determinant:
-Then: Lack of bicep function
-Now: Lack of shoulder ER and forearm supinators anastamosis
-nerve grafting
-removal of scar tissue
-direct anastamosis
Contraindications for OBPP
-any movement before rest before 7-10 dyas post birth
-agressive movements
-precautions for dislocationa and subluxation
3 Tools to Assess Children with OBPP
-Assisting Hand Assessment (AHA): 18m-12 years
-Pediatric Evaluation fo Disability Innventory (PEDI): 6m-7.5yrs
-Pediatric Outcomes Data Collection Instrument (PODCI): 19yrs and younger
