Therapeutic modalities and functional outcome of obstetric brachial plexus palsy about 31 cases
Dr Mariem REKIKa, Dr Aymen HAJ SALAHa, Dr Mouna SGHIRa, Dr Imene KSIBIb, Dr Wafa SAIDa, Prof Wassiaa KESSOMTINIa
a CHU Taher Sfar Mahdia, b Hôpital Militaire Principal d'Instruction de Tunis
The aim of our study is to describe the therapeutic modalities of obstetric brachial plexus palsy (OBPP) and to assess the functional results.
Material and methods:
This is a retrospective study including the OBPP addressed to physical medicine unity of Mahdia from January 2010 to April 2014. The clinical assessment was analytical and functional at the admission, at the third month and every three months, referring to the functional Mallet score.
The data entry and analysis were made by the SPSS 20. In univariate analysis, we studied the relationship between topographic form and Mallet score.
We have collected 31 newborn with female predominance (54%). The average birth weight was 4064g. It was a proximal disorder in 68% of cases, a total one in 19% of cases, a right one in 61% and bilateral in 6%. Claude Bernard Horner's syndrome was observed in 6 patients. Functional rehabilitation was prescribed at the age of 1 month. At 3 months, the muscle groups: triceps-extensor, deltoid and biceps recovered in 41% of cases; the total recovery was 12%. At 6 months, the partial recovery was 77%. Mallet score revealed a normal shoulder in 29% and an intermediate shoulder (stage III-IV) in 45% of cases. In univariate analysis, the Mallet score was significantly dependent on the topographic form (p: 0.04).
Only 6 patients had surgery. The sequelae were dominated by the deficiency in external rotation and supination.
Discussion and Conclusion:
The OBPP remains a significant complication of childbirth. Our experience confirms the interest of early physical therapy to improve functional outcome.
S.Salah and al.: Obstetric brachial plexus palsy in a physical medicine and rehabilitation department. Annals of Physical and Rehabilitation Medicine October 2013, Pages e293-e294
Keywords : obstetric brachial plexus palsy,rehabilitation