Brachial plexus injuries during birth

Neonatal brachial plexus injury is a complication of the delivery process requiring immediate attention from all practitioners involved in the patient’s care. The location and anatomy of the brachial plexus make it vulnerable to injury at birth, and the ensuing deficits can be debilitating. While this injury is uncommon, immediate recognition is important in order to ensure expedient management of the injury and a positive outcome for the child. In the past, research suggested that the vast majority of infant brachial plexus injuries recovered spontaneously. However, in recent years, there has been a shift toward early surgical evaluation as some have noted that more patients than previously thought have persistent and clinically important deficits. The classification of these injuries comprises an important part of the initial evaluation and characterization of the injured infant, and contributes to management decisions alongside radiographic and other clinical testing. Ultimately, a multidisciplinary approach is needed to assure an optimal outcome for injured neonates.