Management of Late Obstetric Brachial Plexus Palsy : Secondary surgical procedures for functional restoration in late obstetric brachial plexus palsy

Over five years an eminent program to support the children with OBPP in Egypt had been established in our Zagazig University hand and reconstructive microsurgery centre (ZUHMC). During this period a lot of children with OBPP were seen, 250 cases from them were below 1.8 months, and they were not improved spontaneously, primary surgery was advised for them. Those who were above 2 years age were thoroughly evaluated to estimate the residual deformities and functional deficits. All children who underwent secondary surgery were reviewed. 111 patients were included in our study.Right sided was more common than left side. Main risk factors were fetal macrosomia, shoulder dystochia, gestational diabetes, and a combination of previous factors. OBPP is a complicated, multi-faceted disorder. Conservative and surgical treatments cannot be separated, but should be used in conjunction. A multidisciplinary approach involving the parents, physiotherapists, neurosurgeons, plastic surgeons, orthopedics surgeons, rehabilitation specialists and psychologists is probably the way to achieve optimal results. However, Prevention may solve this problems as occured for poliomyelitis.