Obstetric Brachial Plexus Injury

Question 1

causes of OBPI

Answer 1

complicated birth
- shoulder dystocia
- use of improper traction
- hyperextension of arms in breeched birth

Question 2

risk factors for OBPI

Answer 2

high birth weight
breech delivery
vaginal, vacuum, or forceps delivery

Question 3

maternal risk factors for OBPI

Answer 3

DM
obesity/excessive weight gain
maternal age >35 y/o
first child birth

Question 4

types of nerve injuries seen in OBPI

Answer 4

avulsion
rupture
neuroma
neuropraxia

Question 5

Level 1 Naraka’s Classification

Answer 5

Erb’s Palsy - C5,6

Question 6

Level 2 Naraka’s Classification

Answer 6

extended Erb’s Palsy
C5-7

Question 7

Level 3 Naraka’s Classification

Answer 7

total palsy
C5-T1

Question 8

Level 4 Naraka’s Classification

Answer 8

total palsy w/ horner’s syndrome
C5-T1

Question 9

s/s of OPBI

Answer 9

abnormal limb tone
decreased limb movement
asymmetric infant reflexes
sensory abnormalities in UE

Question 10

explain certain prognostic signs/indicators

Answer 10

agpar score <7 = poor shoulder outcomes
lack of antigravity biceps action by 3 months = poor indicator for spontaneous recovery
wrist extension = positive prognostic indicator

Question 11

primary interventions include

Answer 11

parent education on positioning, holding, carrying, and playing with infant

protection/prevention

A/PROM

strengthening

modalities

Question 12

what surgical interventions can be indicated for those with OBPI

Answer 12

nerve graft
nerve transfer
muscle transfer
glenohumeral capsule release

Question 13

assistive technologies for patients with OBPI

Answer 13

splinting
dynamic movement orthosis
fabriform shoulder wrap
forearm rotation elbow orthosis