Obstetric Brachial Plexus Palsy of Newborns and Infants: Functional Outcomes after Rehabilitation by Their Own Parents

摘要

Introduction: Obstetric palsy of the brachial plexus (OPBP) is a paralytic lesion common to obstetric trauma, whose clinical presentation varies according to the severity and extent of the root lesions at birth. Early and appropriate rehabilitation is necessary in order to improve the functional prognosis of the injured limb. Under special conditions, parents could carry out this physiotherapy themselves. Objective: The aim of this work was to assess limb functional recovery in newborns and infants with OPBP after rehabilitation by their parents. Patients and Methods: We conducted a prospective study at the NCRDP in Yaoundé over a period of 18 months. We included all patients aged 0 to 2 years with OPBP, isolated or associated with other lesions and followed at least two (02) years at the NCRDP. Results: We recruited 69 cases. The hospital frequency of OPBP was estimated at 1.02%. The age at first consultation was [0 - 28 d] in 50.8% of cases. The sex ratio was 0.68. The right side was reached in 54.4% of cases. The Erb’s palsy predominated in 79.7% of cases. The risk factors for OPBP were vaginal delivery, cephalic presentation, shoulder dystocia and macrosomia. Physiotherapy was performed as prescribed in 94.9% of cases allowing excellent and good functional recovery in 76.81% of cases. Conclusion: In the care of their children’s OPBP rehabilitation by sensitized, actively involved and supervised parents would be a good alternative to professional physiotherapy in all situations where the latter would not be possible.