OBSTETRICAL BRACHIAL-PLEXUS PALSY - RESULTS FOLLOWING NEUROLYSIS OF CONDUCTING NEUROMAS-IN-CONTINUITY

Sixteen infants with conducting neuromas-in-continuity at primary brac hial plexus exploration underwent microsurgical neurolysis of their le sions. For each patient, the immediate preoperative scores for individ ual joint movements were compared with scores at the last examination. In the Erb's palsy group (n = 9), significant improvement was seen in shoulder movements, elbow flexion, supination, and wrist extension (p aired t test, p < 0.05). Clinically useful improvement in function was seen at the shoulder and elbow (Fisher's exact test, p < 0.05). In th e total palsy group (n = 7), significant improvement in shoulder abduc tion, shoulder adduction, elbow flexion, and extension of the wrist, f ingers, and thumb tvas seen (paired t test, p < 0.05), but there was n o significant improvement in the proportion of patients with useful fu nctional outcomes. Neurolysis in Erb's palsy improves both muscle grad e and the functional ability of patients. Neurolysis does not provide useful functional recovery in patients with total plexus palsy.