THERAPEUTIC STRATEGY IN OBSTETRICAL PLEXU S PALSY

The obstetrical palsy of the brachial plexus is a rare but severe comp lication in child delivery. If there is no spontaneous recovery within the first weeks, the child should be considered for a specialized dia gnostic and treatment program with combined care from pediatricians, n eurologists, and physiotherapists and surgeons. Right from the beginni ng physiotherapy is important with its general and specific exercises (Bobath, Vojta); but the decision for further conservative or surgical treatment should be made between 3nd and 6 month. If the biceps is st ill weak or paralyzed at this time, nerve repair should be advised. la ter corrections are tendon transfers for the shoulder, elbow, forearm or hand. Extensive palsies (i.e. thus indicated for surgical repair) s hould not be left to physiotherapy only, because substantial functiona l loss will ensue.