Article

The aim of this investigation was to study the incidence of obstetric
brachial plexus palsy (OBPP), to prospectively follow the recovery process, to
assess the functional outcome at 18 months of age, and to find early prognostic
indicators. METHOD: Of the 38 749 children born between 1999 and 2001 in western
Sweden, 114 (70 males, 44 females) had an OBPP. Ninety-eight children were
examined on six occasions at up to 18 months of age. Muscle strength, range of
motion, hand preference, and functional abilities were noted, and the severity of
the OBPP was classified. RESULTS: The incidence of OBPP was 2.9 per 1000 live
births, and the incidence of persisting OBPP was 0.46 per 1000. At 3 months of
age, the predictive value of regained elbow flexion for complete recovery was
100%, 99% of shoulder external rotation, and 96% of forearm supination. Most of
the 18 children with persisting OBPP could perform functional activities but
asymmetries were noted. Five children had a mild, 11 had a moderate, and two had
a severe impairment. Three had undergone nerve surgery, one with a mild and two
with a severe persisting impairment. INTERPRETATION: Most children with an OBPP
recover completely. Muscle strength at 3 months of age can be used to predict
outcome.

Langue : ANGLAIS