Obstetric Brachial Plexus Palsy

Question 1

Pathophysiology

Answer 1

birth injury
infant’s shoulder becomes stuck during delivery, has to be quickly dislodged in order to avoid respiratory issues
result in shoulder distortia - can stretch the brachial plexus
regeneration depends on degree of nerve injury

Question 2

Long Term Outcomes

Answer 2

if recover by 6 weeks - can have normal shoulder
good results from recovery last up until 3 mths
after that - need surgery

Question 3

Assessment

Answer 3

Newborn

• observe spinal allignment
• observe evidence of muscle length
• observe primitive reflexes
• test DTRs
• observe for tactile sensation

Older

• muscle strength testing
• coordination
• two point discrimination

Question 4

Management

Answer 4

Need to teach the caregivers

• protect their shoulder and UL
• prevent shoulder contracture ER and flexion
• PROM shoulder, elbow, wrist from 5 days old and onwards
• encourage bilateral head turn
• tactile stimulation
• facilitate gross motor development