Brachial plexus microsurgery in children.

摘要: From this review, the following points have emerged: 1. The typical obstetrical palsy is a traumatic lesion caused by forced lowering of shoulder during delivery. 2. While may affect all roots, upper roots are usually ruptured, whereas lower (if involved) always avulsed. 3. Spontaneous recovery possible, but its quality depends on how early previously paralyzed muscles begins. If biceps not started to recover 3 months, final result will be poor. It at time interval that surgical decision should made. 4. Surgical repair grafting, though can difficult if significant numbers avulsions occurred. 5. results reconstruction better than spontaneous evolution, least in those patients who reach age months without evidence biceps. For example, more half nearly normal after grafting C5, C6 lesions Gilbert's series, same control population patients, none achieved spontaneously. 6. Palliative treatment sequelae birth palsies difficult, and obtained rarely totally satisfactory. for these reasons initial intervention plexus itself instances meeting criteria established above. important make as quickly possible before neuroplasticity diminished joint contractions