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GUIDELINES FOR THE CLASSIFICATION, DIAGNOSIS, TREATMENT AND REHABILITATION OF NEWBORNS AND CHILDREN WITH BRACHIAL PLEXUS BIRTH INJURY
ASIJA ROTA ČEPRNJA
; Split University Hospital Center, Department of Physical and Rehabilitation Medicine, Split, Croatia
VALENTINA MATIJEVIĆ
; Department of Rheumatology, Physical Medicine and Rehabilitation, Sestre milosrdnice University Hospital Center, Zagreb; 3Faculty of Dental Medicine and Health, Osijek; 4Libertas International University, Zagreb, Croatia
TATJANA ŠIMUNIĆ
; Department of Physical Medicine and Rehabilitation, Dr Ivo Pedišić General Hospital, Sisak, Croatia
SLAĐANA VUKOVIĆ BAR
; Split University Hospital Center, Department of Physical and Rehabilitation Medicine, Split, Croatia
SANDRA KUZMIČIĆ
; Split University Hospital Center, Department of Physical and Rehabilitation Medicine, Split, Croatia
MLADENKA PARLOV
; Split University Hospital Center, Department of Physical and Rehabilitation Medicine, Split, Croatia
VESNA BILANDŽIĆ
; Split University Hospital Center, Department of Physical and Rehabilitation Medicine, Split, Croatia
DANIJEL MIKULIĆ
; Emergency Department, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
Brachial plexus birth palsy (BPBP) is a neuromotor fl accid paralysis caused by injury to one or more roots of the brachial plexus (BP) during childbirth. It is usually observed shortly after birth. The incidence of BPBP is between 0.5 to 4.4 per 1000 childbirths. Most cases of BPBP are transient and there is a spontaneous, complete recovery of function in the fi rst weeks of life. In some children (20% to 30%), arm weakness persists and leads to neuromuscular dysfunction and permanent disability. In the literature, there are still variations in the classifi cation, diagnosis and treatment of this disorder. They vary from author to author and are based on different studies. The common guideline for habilitation is to restore sensory and motor control, maintain and increase the range of motion, increase muscle strength, encourage bilateral functional activity, and prevent secondary complications. Differences can be seen in the way these tasks are accomplished. There are two basic forms of BPBP treatment, conservative and surgical. Conservative treatment includes intensive kinesitherapy, use of complementary techniques such as electrostimulation, thermotherapy, hydrogymnastics, use of splints, botulinum toxin injections, occupational therapy, etc. Early conservative treatment is the main option in the treatment of BPBP. By reviewing the literature, we noticed that there is no scientifi c evidence for some habilitation techniques used in conservative treatment. They are used in many centers, although their effectiveness has not been proven. Surgical treatment can be primary (neurosurgical) and secondary (orthopedic). There are disagreements in the literature regarding the need for neurosurgical treatment of PBPB and, if decided upon, the age at which it should be performed. The purpose of this research was to review the literature with the aim of assessing the available information on the classifi cation, diagnosis and habilitation prognosis. Due to uneven attitudes in the literature, based on the available scientifi c evidence and personal clinical experiences, we have created our own guidelines for the classifi cation, diagnosis, treatment and habilitation of newborns and children with BPBP. Members of the Section of Pediatric Physiatrists at the Croatian Society for Physical and Rehabilitation Medicine adopted these guidelines (procedure) for the habilitation of children with brachial plexus birth injury at the Congress of Physical and Rehabilitation Medicine in April 2022 in Šibenik.
Keywords
brachial plexus; birth; damage; procedure; diagnosis; habilitation
Hrčak ID:
294725
URI
Publication date:
27.2.2023.
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