A Historical Perspective And Classification Of Obpp

1415 Words May 25th, 2016 6 Pages
Introduction
A historical perspective and classification of OBPP was first described by the Scottish obstetrician William Smellie in an article for midwives in 1764 [1] He documented the observation of resolution of bilateral upper extremity paralysis in a child with face presentation at birth. Danyau performed an autopsy of a newborn with brachial plexus palsy in 1851, providing the first anatomic description of this lesion.[2] but classic description of shoulder paralysis, internal rotation contracture and waiter’s tip deformity was given by Erb in 1874 as cited by Gilbert A et al. [3,4]. Duchenne and Balliere and Erb described cases of upper trunk nerve injury, attributing the findings to traction on the upper trunk, now called Erb’s palsy (or Duchenne-Erb’s palsy).[5] In 1885, the French neurologist Augusta Klumpke [6] described the clinical picture of OBPP affecting the lower plexus trunk at C8-Th1, leading to paralysis of the muscles of the hand and ipsilateral pupillary dilatation, called Horners sign. Therefore, OBPP affecting the lower trunk is often referred to as Klumpkes palsy. OBPP diagnosed at birth is defined into three groups in accordance with the International Classification of Diseases :
• P 14.0 Erbs palsy caused by injury at delivery
• P 14.1 Klumpkes palsy caused by injury at delivery
• P 14.3 Other injury of the brachial plexus at delivery
P 14.0 and P 14.1 are the most common diagnoses. P 14.3 is rarely used and seems to be applied in cases with…
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