Sensory evaluation of the hands in children with brachial plexus birth injury.

The aim of this study was to examine sensory changes of the hand in brachial plexus birth injury (BPBI). Ninety-five patients (43 females, 52 males) comprising two age groups, 6 to 8 years (mean age 7y 6mo) and 12 to 14 years (mean age 13y 2mo), were included. Sixty-four had upper (cervical [C] 5-6), 19 upper and middle (C5-7), and 12 had total (C5-thoracic (Th)1) plexus injury. Obstetric plexus surgery had been performed on 14 patients at the age of 1 to 6 months. The sensibility of 32 palmar areas of both hands was tested with Semmes-Weinstein filaments (calibres 2.83, 3.61, 4.31, 4.56, and 6.65). In upper plexus injuries, abnormal values (4.31-4.56) were recorded in seven out of 64 affected hands. In C5-7 and total plexus-involvement, decreased sensibility was found in five out of 19 (4.31-6.65) and in four out of 12 (4.31-no sensation) affected hands respectively. Conservatively treated patients had better sensation than those treated surgically. Sensory recovery of the hands in BPBI is generally good, especially in upper plexus injuries. Impairment of fine sensation is not uncommon in more extensive permanent BPBI. In total injuries, protective sensation of the hand is not always restored.