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Evidence summaries

Effectiveness of Primary Conservative Management for Infants with Obstetric Brachial Plexus Palsy

There is inconclusive evidence on the effectiveness of primary conservative management for infants with obstetric brachial plexus palsy. Level of evidence: "D"

A systematic review 1 including 8 studies (2 cross-sectional comparative studies, 1 retrospective comparative study, 2 prospective case series and 3 retrospective case series) with a total of 751 subjects was abstracted in DARE. The recovery rates ranged from 17 to 100%; most studies reported the attainment of normal or near normal function in more than 80% of the included participants. 3 studies compared conservative management with surgery and provided conflicting evidence on their relative effectiveness. 2 studies documented recovery in terms of severity of brachial plexus lesion: 1 showed that infants with minor lesions recover in less than 1 month following birth with conservative management, whereas the other showed that surgical management achieved a greater active shoulder range of motion compared with conservative management in infants with minor lesions.

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies).

References

  • Bialocerkowski A, Kurlowicz K, Vladusci S, Grimmer K. Effectiveness of primary conservative management for infants with obstetric brachial plexus palsy. International Journal of Evidence-Based Healthcare 2005;3:27-44. [DARE]

Primary/Secondary Keywords