Kurt Fatih, Erdem Sultanoglu Tuba
Pediatrics, Duzce University, Duzce, TUR.
Physical Medicine and Rehabilitation, Duzce University, Duzce, TUR.
Cureus. 2024 Nov 15;16(11):e73782. doi: 10.7759/cureus.73782. eCollection 2024 Nov.
Obstetric brachial plexus injury (OBPI) is an important preventable complication of the birth process. While most cases recover in the early period, a substantial number result in sequelae. Despite established risk factors, there are cases that occur without any apparent risk factors. Our study aims to identify prenatal risk factors by examining OBPI cases born in our hospital and to provide insights into the prognosis of the disease by comparing cases with panplexopathy to those without. We included 31 cases followed for OBPI in our hospital. Risk factors related to the infant and the mother were investigated. The range of motion (ROM) measurements of the affected upper extremity joints, muscle strength, atrophy, and scoliosis status were evaluated. Of the cases, 71% were girls, and 61.3% had left-sided involvement. Additionally, 84.1% had risk factors, with oxytocin administration being the most frequently identified risk factor. In our study, we compared cases with panplexopathy to those without. Shoulder abduction, shoulder adduction, wrist flexion, and wrist extension restrictions were significantly more common in cases with panplexopathy. Furthermore, muscle atrophy was significantly more frequent in the panplexopathy group. Since OBPI is a preventable injury, identifying risk factors is crucial. However, there are conflicting results regarding the most significant risk factor. Our study highlights that oxytocin administration is a very important risk factor for OBPI. We found that cases with panplexopathy had a worse prognosis, with more frequent ROM limitations and muscle atrophy.
产科臂丛神经损伤(OBPI)是分娩过程中一种重要的可预防并发症。虽然大多数病例在早期会恢复,但仍有相当数量会导致后遗症。尽管存在已确定的风险因素,但仍有一些病例在没有任何明显风险因素的情况下发生。我们的研究旨在通过检查在我院出生的OBPI病例来确定产前风险因素,并通过比较全臂丛神经病变病例和无此病变病例来深入了解该疾病的预后。我们纳入了我院31例接受OBPI随访的病例。对与婴儿和母亲相关的风险因素进行了调查。评估了患侧上肢关节的活动范围(ROM)测量值、肌肉力量、萎缩情况和脊柱侧弯状况。在这些病例中,71%为女孩,61.3%为左侧受累。此外,84.1%有风险因素,使用催产素是最常确定的风险因素。在我们的研究中,我们比较了全臂丛神经病变病例和无此病变病例。全臂丛神经病变病例中,肩关节外展、内收、腕关节屈曲和伸展受限明显更常见。此外,全臂丛神经病变组肌肉萎缩明显更频繁。由于OBPI是一种可预防的损伤,识别风险因素至关重要。然而,关于最重要的风险因素存在相互矛盾的结果。我们的研究强调,使用催产素是OBPI的一个非常重要的风险因素。我们发现,全臂丛神经病变病例的预后较差,ROM受限和肌肉萎缩更频繁。