Management of obstetric brachial plexus palsy

Advances in reconstructive microsurgery during the last quarter of the century have led to an increasing interest in brachial plexus surgery in infants. The higher potential for nerve regeneration in this patient population as compared to adults with post-traumatic brachial plexus injuries, allowed for more aggressive surgical approaches. Even if the current thinking is that surgery at an early stage is the best therapeutic modality for obstetric brachial plexus palsies, there is still some controversy among reconstructive microsurgeons around the world regarding appropriate candidates, the optimal timing of surgery, and the best reconstruction approaches. This article condenses current opinions and presents the authors' approach to this debilitating disease.