AIM To conduct a retrospective study of cases of congenital brachial palsy, focusing on its incidence, clinical manifestations and long-term course.
PATIENTS AND METHODS A systematised study of all the cases of congenital brachial palsy detected in the Hospital La Paz between January 1994 and December 2003 was carried out with the aim of recording data on the pregnancy, gestational age, type of delivery, presentation, sex and weight at birth, Apgar test and the arterial pH of the umbilical cord. It also sought to estimate the type of brachial palsy, the side that was affected, electromyographic findings, associated insults, treatment and progress.
RESULTS Congenital brachial palsy was diagnosed in 48 patients. All the children, except one, were born full term and in over half the cases (54.1%) weight at birth was above average. In 43 cases presentation was cephalic and in the other 5 it was footling. Twenty-nine cases (60.5%) were classified as mild, 12 were moderate (25%) and 7 were severe (14.5%). Electromyogram studies were carried out in 19 patients (39.5%) and the following insults were found: severe axonotmesis in the 7 severe patients, moderate axonotmesis in the 10 moderate patients, and neuroapraxia and mild axonotmesis in the 2 mild patients.
CONCLUSIONS The incidence of congenital brachial palsy in our hospital was 0.6 cases/1000 births/year. Proximal brachial palsy was the commonest disorder, although in most cases patients were only mildly affected and were free of sequelae when discharged. Functional limitations persisted, however, in 36.6% of the cases despite treatment being established at an early stage.
KeywordsAxonotmesisCongenital brachial palsyMacrosomic newbornNeuroapraxiaProximal brachial palsySequelae of brachial palsy
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