OBSTETRIC BRACHIAL-PLEXUS PALSY ASSOCIATED WITH BREECH DELIVERY - A DIFFERENT PATTERN OF INJURY

Most obstetric brachial plexus palsies are due to rupture of the upper roots in babies whose delivery was complicated by shoulder dystocia. If treated by early exploration and grafting, they have a favourable p rognosis. We reviewed 36 babies who had had an obstetric brachial plex us palsy after a breech delivery and found that they had a different p attern of injury; 81% had avulsion of the upper roots. This injury can not be treated satisfactorily by exploration and microsurgical graftin g and carries a considerably worse prognosis for shoulder function.