Becoming of childhood’s obstetrical plexopathies in Cotonou

Dr Hountondji Etienne ALAGNIDEa, Dr Didier NIAMA NATTAa, Dr Mabèrou Germain HOUNGBEDJIa, Dr Herman AZANMASSOa, Mr Melchior CAKPOa, Prof Godonou Toussaint KPADONOUa

a Service de Médecine Physique et Réadaptation/ CNHU-HKM (Cotonou)

Obstetrical paralysis of the brachial plexus (OPBP) is one of the most handicaping pathologies of the thoracic member of childhood in African environment with diverse repercussions on the family [ 1 ]. Objective: estimate becoming of children affected by OPBP

Method: Transverse Study with descriptive and analytical aim, about 109 cases of OPBP followed in the department of Functional Reeducation and Rehabilitation (DFRR) of the CNHU-HKM of Cotonou from January, 2000 till December, 2009. These children were seen again in 2013 for the evaluation of their social and clinical becoming (articular mobility, strength and muscular trophicity).

Results: the annual average frequency of the OPBP was 10,9. Cases were dominant with boys (54 %) and on the right thoracic member (57 %). The children are from 3 to 15 years old. The risk factors of OPBP were: multiparity (90 %), birth weight more than 4000g (78 %), childbirth by low way (87 %), cephalic presentation (57 %). An average of 22 sessions of physiotherapy by child was made. The evolution of the clinical status was an improvement (50 %), a status quo (27 %) and a worsening (23 %). The clinical becoming was the obstinacy or the occurrence of orthopaedic deformations of thoracic member (15-40 %), limitation of joint motion (27 %), muscular atrophy (24 %), muscular paresis (61 %), various functional limitations observed on the thoracic member (13-53 %). Professional becoming of the children does not seem to be mortgaged: 83 % were schooled and 17 % apprenticed.
Discussion Conclusion: Different strategies of taking care about OPBP remain still limited: diverse deficiencies persist at these child's. Prevention has to be the key word.

[1] DeMatteo C, Bain JR, Gjertsen D, Harper JA. 'Wondering and waiting' after obstetrical brachial plexus injury: Are we underestimating the effects of the traumatic experience on the families? Can J Plast Surg. 2014 Fall;22(3):183-7.

Keywords : Becoming, obstetric Paralysis brachial plexus, child, Cotonou