William, french 1 month old baby

[katep]

Pierre,

I'm sorry, I couldn't find many. The one I posted, and the other I forgot the link. Here it is:

"Obstetric Brachial Plexus Injuries Following Breech Delivery: An Adverse Experience in The Netherlands"
http://www.ncbi.nlm.nih.gov/pmc/article ... s18301.pdf
This one has a lot of details about which nerves were used for transfer, with a decent success rate.

It seems there are not many articles that discuss neurotization (nerve transfer) in the context of intact lower roots but avulsed upper roots (breech deliveries). I'm sure because it is so very uncommon. The typical surgery is addressing nerve transfer for lower root avulsion, so the lower roots are neurotized to the upper plexus typically. But it seems that upper plexus avulsions are more often connected to nerves outside the plexus. That is the basis for my gut feeling of wanting a surgeon who has seen the highest possible number of OBPI patients. This type of injury demands a very different approach, and even the most prolific surgeon wouldn't see many cases over an entire career.

Kate

[pmali]

you're right.
thanks for the articl! I found also different other ones:

Clinical and neuropathological study about the neurotization of the suprascapular nerve in obstetric brachial plexus lesions

Dominique Schaakxs1 email, Jörg Bahm2 email, Bernd Sellhaus1 email and Joachim Weis1 email

1 Institute for Neuropathology, Klinikum RWTH Aachen, Germany

2 Euregio Reconstructive Microsurgery Unit, Franziskushospital Aachen, Germany

Oberlin's ulnar nerve transfer to the biceps nerve in Erb's birth palsy.
Plast Reconstr Surg. 2002 Jan;109(1):405-7.

Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report
Koji Shigematsu email, Hiroshi Yajima email, Yasunori Kobata email, Kenji Kawamura email, Naoki Maegawa email and Yoshinori Takakura email
Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan

Some results are quite very good!

THe journal of brachial plexus and peripheral nerve injury is very dense of detailed articles.

Thanks again and happy new year!!

[pmali]

Dear all

we just came back from Paris where we had good news (Hospital Trousseau, Dr Romana)

Benjamin is recovering his deltoid muscle (grade 3) and also a little bit his biceps (grade 1)

It was very good news since my fear was C5-C6 avulsion (which can be excluded now)

We have to wait for one more month to see if he'll be able to bend his elbow up to his mouth.

Otherwise probably there will be a classical surgery (C5-C6 nerve grafts) with a good prognosis.

Thanks again!

[katep]

I am so glad to hear this news! Thanks for updating us. I'm glad his prognosis is improving... there's still room to improve even more You are in our prayers.

Kate

[Carolyn J]

Benjamin and you,Mom & Dad, are all in my Prayers.
Thank You for your update.
Carolyn J
LOBPI/72