NEUROSURGICAL CORRECTION OF UPPER BRACHIAL-PLEXUS BIRTH INJURIES

The authors review the cases of 116 infants treated consecutively for birth-related brachial plexus injuries. Twenty-eight infants with uppe r brachial plexus lesions who showed no neurological improvement by 4 months of age were selected for early surgical reconstruction (at a me an age of 5 months). Neurological improvement of the affected arm was observed in more than 90% (p < 0.05) of the children examined longer t han 9 months after brachial plexus reconstruction. A conservatively ma naged control subgroup of 44 children, first examined at less than 3 m onths of age, demonstrated neurological improvement by 4 months of age and continued to show improvement at 1 year of age. Early surgical re construction is recommended for infants with birth-related upper brach ial plexus injury who show no neurological improvement by the age of 4 months.