Brachial Plexus Birth Injury: Current Concepts in Its Assessment and Management

Brachial plexus birth injury is an uncommon but serious obstetric complication. It follows a highly variable course, with outcomes ranging from mild transient impairment to significant lifelong disability. Infants with brachial plexus birth injuries require careful, regular monitoring to guide decision-making about the treatment and management of the condition. A variety of techniques may be implemented in the conservative management of brachial plexus birth injury. These aim to ensure a full range of motion and to prevent muscle imbalances. Surgical management varies but predominantly involves microsurgical nerve grafting and nerve transfers. This may be followed later by further orthopedic procedures depending on the needs of the patient. Despite the long history of this condition in the medical literature, there continues to be broad variations between the management pathways favored by different treatment centers. International research groups are now working to establish a minimum standard of patient outcome data to facilitate more effective future research on this topic. This article summarizes the current strategies used in the assessment and management of patients with brachial plexus birth injury.