Obstetrical brachial plexus injuries: incidence, natural course and shoulder contracture

The incidence of obstetric brachial plexus injury (OBPI) was investigated a nd the natural course of this disorder and the frequency of shoulder contra cture described. Between 1988 and 1997 13 366 children with a gestational a ge of 30 weeks or more, were born at the Academic Medical Center, Amsterdam . Of these, 62 had an OBPI (4.6 per 1000). Complete neurological recovery o ccurred in 72.6% of cases. Half of them had a delayed recovery of more than three weeks (mean recovery time 6.2 +/- 3.1 months). Shoulder contracture occurred in at least one-third of the children with delayed recovery and in at least two-thirds of the children with incomplete recovery. The incidenc e of OBPI in our hospital was found to be higher and to have a less favoura ble natural course than is usually reported in the literature. Contracture of the shoulder joint is frequently found even in infants with complete neu rological recovery.