Article
Immobilizing therapy in the treatment of obstetrical brachial plexus injuries
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Published: | September 27, 2011 |
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The majority of cases of obstetrical plexus palsies are mild traction injuries which resolve under physical therapy within several weeks or months. In cases of severe ruptures or avulsion injuries of the brachial plexus lifelong impairment of the upper extremities can occur. Hence, the indications for plexus reconstruction in severe injuries should be evaluated, early. At the age of about 3 months, the infant should be presented in a centre specialized in obstetrical brachial plexus palsies. In almost all cases intensive physical therapy is performed. In addition, many patients require splinting in order to gain function as part of the conservative therapy or for postoperative fixation. Depending on the type of splint, different demands are made on design, material and strategy of adjustment. Many different natural and synthetic materials are available for orthopedic constructions. Because of its good adjustment options, the use of low temperature thermoplastic is steadily increasing. Here we present an illustrated overview of our currently used splints and new technical developments in our experience with more than 200 patients with obstetrical brachial plexus palsy. We present our experience and technical details with the most common splints for the use in fixation after birth-related brachial plexus surgery, subscapularis release, trapezius muscle transfer and functional improvement of hands with a lack of wrist extension.