Document Detail

The Evidence for Nerve Repair in Obstetric Brachial Plexus Palsy Revisited.
MedLine Citation:
PMID:  24551845     Owner:  NLM     Status:  Publisher    
Strong scientific validation for nerve reconstructive surgery in infants with Obstetric Brachial Plexus Palsy is lacking, as no randomized trial comparing surgical reconstruction versus conservative treatment has been performed. A systematic review of the literature was performed to identify studies that compare nerve reconstruction to conservative treatment, including neurolysis. Nine papers were identified that directly compared the two treatment modalities. Eight of these were classified as level 4 evidence and one as level 5 evidence. All nine papers were evaluated in detail to describe strong and weak points in the methodology, and the outcomes from all studies were presented. Pooling of data was not possible due to differences in patient selection for surgery and outcome measures. The general consensus is that nerve reconstruction is indicated when the result of nerve surgery is assumedly better than the expected natural recovery, when spontaneous recovery is absent or severely delayed. The papers differed in methodology on how the cut-off point to select infants for nerve reconstructive surgical therapy should be determined. The justification for nerve reconstruction is further discussed.
Willem Pondaag; Martijn J A Malessy
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Publication Detail:
Type:  REVIEW     Date:  2014-1-16
Journal Detail:
Title:  BioMed research international     Volume:  2014     ISSN:  2314-6141     ISO Abbreviation:  Biomed Res Int     Publication Date:  2014  
Date Detail:
Created Date:  2014-2-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101600173     Medline TA:  Biomed Res Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  434619     Citation Subset:  -    
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