This Palsy can occur as a result of the birthing process, most commonly when a shoulder becomes lodged while in the birth canal. The large network of nerves that run between the neck and shoulder are known as the Brachial Plexus. It is when nerves are temporarily or permanently damaged that reconstructive surgery may be required in addition to physiotherapy to optimise the arm and hand function in the treatment of Obstetric Brachial Plexus Palsy. Dr Thomas’s appointment at The Royal Children’s Hospital, Melbourne see him as part of the hand and microsurgeons involved in the multidisciplinary team to treat Obstetric Brachial Plexus Palsy.
Obstetric Brachial Plexus Palsy affects the messages the brain tries to send through the nerves to the arm. The baby may have muscle weakness, not be able to move their arm and muscle wastage will occur if left untreated. The babies’ sensitivity to heat and or pain may also be impacted.
Candidates for Obstetric Brachial Plexus Palsy treatment include:
- Babies who are assessed to have an injury that nerve reconstructive surgery will provide an improved long term functional outcome.
- As a child grows there may be muscle or tendons transfers around the shoulder, elbow, wrist and hand that can assist function.
About the procedure
Surgery is performed under general anaesthetic. Nerves that require reconstruction are carefully resected, and replaced by spare nerves from the leg(s) as nerve grafts. Nerve transfers may also be performed instead of or as well as nerve grafting.
What to expect after the procedure
Following the recovery from the surgical procedure a comprehensive physiotherapy program will follow to optimise the recovery chances.