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Controversies in Neurology
July 2006

Early Operative Intervention for Selected Cases of Brachial Plexus Birth Injury

Author Affiliations

Author Affiliations: Brachial Plexus Programs, Miami Children's Hospital, Miami, Fla, and Hospital for Joint Diseases, New York, NY.


E. S.RoachMD

Arch Neurol. 2006;63(7):1031-1032. doi:10.1001/archneur.63.7.1031

Much controversy continues to surround the treatment of infants with brachial plexus birth injuries. It centers primarily on questions concerning the indications, timing, and results of early operative intervention with microsurgical nerve reconstruction.1 A careful evaluation of some available studies on the natural history of the injury2-10 and some surgical outcome data11-13 make it possible to develop a reasonable treatment strategy for these patients. Despite some conflicting reports,14-16 probably more than 70% of all infants presenting with a brachial plexus injury at birth will have a very good ongoing spontaneous recovery throughout the extremity. Therefore, only a small number of these patients are potential candidates for early nerve surgery.

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