Birth Brachial Plexus Injury

With one of the nation’s largest groups of pediatric orthopedic specialists, a team of skilled pediatric neurosurgeons, and the nation’s highest concentration of pediatric rehabilitation medicine specialists, Gillette Children’s Specialty Healthcare provides superior care for patients who experience birth brachial plexus injuries.

Our Brachial Plexus Clinic offers a comprehensive program for evaluating and treating children whose brachial plexus injuries occurred at birth. We help our patients achieve their highest possible levels of independence, comfort and happiness in a family-centered environment.

Why Choose Gillette?

  • Gillette is a nationally and internationally recognized leader in pediatric orthopedics and a regional leader in neurosurgery.
  • We have the nation’s highest concentration of pediatric rehabilitation medicine specialists.
  • Our pediatric orthopedists, neurosurgeons and rehabilitation specialists collaborate during a single clinic visit, offering superior care and convenience for families.
  • We offer an extensive, interdisciplinary team of experts to provide services tailored to each patient’s and family’s needs.
  • Our facilities and technology are designed specifically for babies who have brachial plexus injuries.

Birth Brachial Plexus Injury Definition

The brachial plexus is a network of nerves that begins at the spinal cord in the neck and allows messages from the brain to reach the shoulder, arm and hand. Birth brachial plexus injuries occur when this network of nerves becomes damaged during birth. The injuries can cause problems controlling movements and feeling sensation in the hand, wrist, elbow and shoulder.

Causes of Birth Brachial Plexus Injuries

Brachial plexus injuries occur when the nerves are stretched or torn. Some happen during the birth process. The baby's shoulders might become wedged within the birth canal, causing the brachial plexus nerves to stretch or tear as the baby passes through.

Birth Brachial Plexus Injury Risk Factors

Approximately two babies in 1,000 experience brachial plexus injuries at birth. About one in 10 of those infants needs surgical treatment; others recover full nerve function through physical or occupational therapy alone.

Difficult births, such as breech births or births involving prolonged labor, increase a baby’s risk of experiencing a brachial plexus injury. Many babies with brachial plexus injuries are larger than average at birth. However, newborns of all sizes can have such injuries—even premature babies.

Symptoms of Birth Brachial Plexus Injuries

Brachial plexus injuries have different symptoms and effects, depending on the child's age and the extent of the injury. Often, a child who has a brachial plexus injury:

  • Can move the shoulder or elbow, but has trouble moving the wrist and hand
  • Can move the hand, but cannot move the shoulder or elbow
  • Cannot move or feel either the arm or hand

Watch for these symptoms. By 3 months of age, children who have a brachial plexus injury might be unable to:

  • Squeeze your fingers
  • Bend their wrist
  • Bend and straighten their elbow
  • Raise their arm

A brachial plexus injury occurring during or shortly after birth can result in lifelong consequences, impairing use of the shoulder, elbow, arm, wrist and hand. Babies and children who appear to have problems with movement should receive an evaluation from specialists who can make a diagnosis and develop a comprehensive treatment plan.

Diagnosing Birth Brachial Plexus Injuries

Early identification and treatment of brachial plexus injuries is vital to reducing both long-term effects and the need for invasive or surgical corrections. Babies who don’t use an arm for an extended time ultimately might need extensive surgery to correct bone and muscle alignment. Babies suspected of having brachial plexus injuries should receive evaluations from experienced specialists during the first few months of life, if possible. Early treatment produces the best results.

As part of a comprehensive evaluation, Gillette uses one or more of the following tests to help diagnose a brachial plexus injury and determine its extent and severity:

Birth Brachial Plexus Injury Treatments

Therapeutic treatment is most effective in babies diagnosed at 3 to 6 months. Most children will regain full use of their arm and hand through physical and/or occupational therapy alone. Children who are diagnosed with birth brachial plexus injury later in life might benefit from upper extremity functional and intensive therapy (UFIT).

If the condition doesn’t resolve with therapy alone, Gillette offers surgery that—combined with postsurgical therapy—can improve motor function. Our surgeons might implant nerve guides, perform nerve grafts or perform neurolysis to increase input to muscles.

For children who do not regain motor function, have severe brachial plexus injuries, and/or have injuries left untreated for too long, our orthopedic surgeons might need to correct secondary bone, joint and muscle deformities.

Our Birth Brachial Plexus Injury Services

Gillette’s comprehensive Brachial Plexus Clinic includes pediatric orthopedists, pediatric neurosurgeons, pediatric rehabilitation medicine physicians, and rehabilitation therapists who have extensive experience diagnosing and managing birth brachial plexus injuries.

Specialties and services most often involved in birth brachial plexus injuries include:

Drawing upon these areas of expertise, we form interdisciplinary teams to evaluate, diagnose and develop treatment plans for each patient. Our team approach often lets patients see multiple specialists during one visit at one location. Our goal is to support families with care that’s comprehensive and convenient.

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