Obstetric brachial plexus palsy of upper trunk injury (nerve swelling)- brachial plexus exploration lysis swollen nerve resection nerve grafting.doc

 PAGE \* MERGEFORMAT 10 Obstetric brachial plexus palsy of upper trunk injury (nerve swelling): brachial plexus exploration lysis swollen nerve resection nerve grafting A clinical data Children, female, 8 months. After birth, right elbow, right shoulder movement due to failure of 8 months to hospital for treatment. Due January 18, 1997 after the birth of the right upper limb movement and completely taken out, a month after resumption of finger extension, 6 months after the shoulder and elbow joints has been restored. Examination: conscious, head and neck normal. Heart rate, breathing normal, no abnormal heart and lung auscultation. Abdominal flat without tenderness, liver and spleen is not, and normal bowel sounds. Right upper limb examination: pre-push test was negative. Shoulder on the move can not, and outreach to moderate external rotation was limited to normal adduction. Deltoid and supraspinatus muscle atrophy (~), muscle strength M-2; moderate elbow flexion was limited to normal extension. Biceps muscle atrophy (~), triceps atrophy (~), biceps muscle M-2, triceps muscle strength M4. Wrist and hand examination of : Wrist extensor pollicis slightly restricted, flexor normal hyperalgesia. Case characteristics: (1) girl, 8 months; (2) failure after birth, the whole history of right upper limb; (3) head position dystocia, birth weight 4000g; (4) right upper shoulder and elbow after birth, can not play sports, 1 month after the finger may be flexion; (5) examination: shoulder joint on the move can not, and outreach to moderate external rotation was limited adduction normal. Deltoid and supraspinatus muscle atrophy (~), muscle strength M-2; severely restricted elbow flexion, extension and normal. Biceps muscle atrophy (~), triceps atrophy (~), biceps muscle M-2, triceps muscle strength M4. Wrist and hand inspection: wrist extensor pollicis slightly restricted, is that normal, lateral arm pain subside. (6) electromyography examination; (7) X-ray film humeral