A Brief Note On The Mechanism Of Injury

2184 Words May 25th, 2016 9 Pages
Mechanism of injury:
Obstetric brachial plexus palsy is caused by traction to the brachial plexus during labour. In the majority of cases delivery of the upper shoulder is blocked by the mother’s pubic symphysis (shoulder dystocia). If additional traction is applied to the child’s head, the angle between the neck and the shoulder is forcefully widened, overstretching the ipsilateral brachial plexus. Recently, the exact origin of OBPP was again a matter of debate. It was suggested that intrauterine maladaptation, not nerve traction, causes the plexopathy. [43]
However OBPP at birth is one of the causes of permanent neurological disability. The delivery process is associated with several factors which, together, may result in OBPP in the newborn but it is difficult to predict OBPP based on antenatally available information. Despite extensive research one OBPP, there is no generally accepted strategy for prevention. [7]
Fortunately, Permanent damage to the upper roots is uncommon. Usual involvement is of the suprascapular, axillary and musculocutaneous nerves. Muscles most often paralyzed are supraspinatus and infraspinatus supplied by the suprascapular nerve, which is fixed between two points and does not accommodate stretching. In more severely affected patients, deltoid, biceps, brachialis and subscapularis are also involved. Patients with C5 and C6 palsies usually have residual weakness of rhomboids and serratus anterior leading to mild winging of scapula, an acceptable…
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