Characteristics and outcomes of obstetric brachial plexus palsy in a single Saudi center: an experience of ten years

Int Orthop. 2018 Sep;42(9):2181-2188. doi: 10.1007/s00264-018-3975-y. Epub 2018 May 18.

Abstract

Background: Obstetric brachial plexus palsy (OBPP) is considered a rare, unpredictable, and unavoidable injury of the upper limb. In this study, we presented a retrospective cohort study over a period of ten years in King Faisal Specialists Hospital and Research Centre (KFSH&RC), Riyadh, Saudi Arabia, to assess the characteristics and functional outcomes of OBPP.

Methods: Between January 2005 and December 2015, we carried out 125 repairs of OBPP in KFSH&RC. Out of 71 girls and 54 boys, two babies died of unrelated causes, so they were excluded from the review. All medical records of the patients who attended OBPP clinic at KFSH&RC were reviewed, and relative data were extracted. Descriptive measures for categorical variables and categorical variables were presented. Student's t test and Pearson's χ2 test were used. The level of statistical significance was set at P ≤ 0.05.

Results: A total of 123 patients were included in the study with a mean follow-up of 6.1 ± 2.4 years. Of those, 71 (57.7%) were females. Mean age at presentation was 4.2 ± 2.7 months with a birth weight of 3965.9 ± 629.6 g. More than half of the patients (56.1%) sustained the injury in the right side, and 62 patients (50.4%) were classified as Narakas I. Most of the surgeries (96.7%) were nerve grafting. Only 32 (26.0%) patients needed one or more secondary interventions. In the last visit, the mean total score of Mallet was 16.6 ± 2.8. Also, passive external rotation in adduction improved to 38.3 ± 14.5. Last Raimondi hand function grade was 2 ± 1.

Discussion: Our experience demonstrated the value of primary and secondary surgeries in patients with OBPP. Also, we presented the patterns of injury in Saudi patients presented to KFSH&RC.

Keywords: Brachial plexus repair; Characteristics; Obstetric brachial plexus palsy; Recovery of function; Saudi Arabia.

MeSH terms

  • Brachial Plexus / injuries
  • Brachial Plexus Neuropathies / epidemiology
  • Brachial Plexus Neuropathies / surgery*
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Male
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / statistics & numerical data*
  • Pregnancy
  • Recovery of Function
  • Retrospective Studies
  • Saudi Arabia / epidemiology