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Brachial Plexus Birth Palsy & Glenohumeral Dysplasia

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Contrary to some nihilistic views on the future of children with brachial plexus birth palsy, this section outlines how prevention and treatment are both effective and fundamental. Preventing and treating problems arising from BPBP is also a key factor that should be taken into consideration.

BPBP and glenohumeral dysplasia highlights:
 

Brachial Plexus Birth Palsy

  • Occurs when the collection of nerves around the shoulder is damaged during birth.
  • Early surgical consultation is strongly advised.
  • Precocious passive joint movements are fundamental, focusing on the external rotation of the shoulder.
  • Early surgical repair is recommended for avulsions (3 months of age). Surgical repair for ruptures is recommended at the age of 5 months, if there is no recovery of elbow flexion against gravity.
  • Electromyography is useless. Occasionally, MRI may be indicated.
     

Glenohumeral Dysplasia

  • The aftermath of the shoulder is the predominant motion alteration in children affected with BPBP.
  • Early physiotherapy in infants with BPBP prevents further shoulder problems. It must be executed from the beginning by the parents, mainly focusing on passive external rotation exercises.
  • Suspect glenohumeral dysplasia if passive shoulder external rotation is not possible.
  • Nonsurgical treatment described by Dr Soldado provides patients with better outcomes than surgery, by regaining shoulder external rotation and protecting against loss of internal rotation.
Obstetric brachial palsy
Brachial Plexus Birth Palsy: Definition and Mechanisms of Injury:
Risk of brachial plexus birth palsy. Necessary diagnostic tests.
BPBP treatment: physical therapy and surgery
Shoulder problems in children with BPBP
Prevention and Risk of IRCS and DGH
Diagnosis and Treatment of Shoulder Dysplasia
What doctor does my baby need?
Clinical experience of Dr Soldado
Malformations
Short or absent thumb: thumb hypoplasia
Deviated wrist: radial and ulnar clubhand
Short fingers: Brachydactyly, symbrachydactyly, amniotic band syndrome
Less fingers: cleft hand and ulnar clubhand
Extra fingers or thumb: Polydactyly
Glued fingers or syndactyly
Cerebral Palsy
Definition, overview and assessment of cerebral palsy
Upper extremity problems in children with spastic hemiparesis
Nonsurgical treatment of spastic hemiparesis
The upper extremity in cerebral palsy with spastic tetraparesis
Surgical treatment of spastic hemiparesis
Microsurgery
Pediatric vascular microsurgery: overview
Bone loss reconstruction I: Vascularized fibula transfer
Bone loss reconstruction II: Periosteum transfer of vascularized fibula
Bone recalcitrant nonunion or pseudoarthrosis
Bone revascularization (osteonecrosis, aseptic necrosis)
Joint reconstruction. Transfer of epiphysis and growth plate of the vascularized fibula
Reimplantation and revascularization
Functional muscle transfer (vascularized and innervated)
Skin loss coverage
Fractures/Injuries
Overview of fractures
Typical bone fractures in children
Treatment of fractures in children: overview
Classification and treatment of physeal fractures
Fractures of the shoulder girdle, shoulder and arm of the child
Elbow fractures of the child
Fractures of the forearm and wrist of the child
Hand fractures in children
Upper extremity injuries of the child
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Cooperación internacional: Misiones quirúrgicas
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