In our clinic, we see over 1,500 children visits each year. The vast majority of our children do have one or more classical risk factors for obstetric injury in their history.
The prognosis depends on the severity of injury, and the level of injury. In our experience, early surgery in appropriate patients results in better outcomes.
becomes critical because in 12 to 18 months following injury,
denervated muscles will not accept a new nerve supply, and
remain paralyzed or weak permanently. Because nerves only
grow back at one inch per month, time is of the essence
in managing these and any other nerve injuries.
A commonly held belief is that 85 to 90% of these injuries recover completely.In our experience of 15 years and several thousand patients, this is not accurate, and although the actual number of patients who recover 100% function in a few days or weeks is unknown, it is our firm belief that the presence of any disability at 3 months following birth injury requires evaluation by a surgical specialist.
This does not imply that all of these patients require surgery, but that surgical specialists who deal with obstetric palsy routinely should be involved relatively early so that the time clock of muscle atrophy is managed appropriately. It is also important to include a surgical specialist in your consultation group because many non-surgical physicians are simply unaware of the benefits and new techniques available for functional restoration.
Because the overall spectrum of injury is so diverse, and because
experience dictates specific management for each child,
consultation with a specialist is critical to maximize outcome.