Staged Shoulder and Elbow Reconstruction in a Child with Obstetric Brachial Plexus Palsy: Six-year Follow-up.

What was studied

A single case report of a late-presenting adolescent girl with severe left shoulder and elbow flexor paralysis from obstetric brachial plexus palsy, treated with staged reconstructive surgery (trapezius and latissimus/teres major transfer for shoulder function, flexor-pronator transfer for elbow flexion), followed for 6 years.

Key findings

• This is a single case report; no comparative or cohort data are presented.
• Flexor-pronator transfer successfully restored elbow flexion and function, maintaining joint stability over the long term.
• Shoulder function improved less remarkably than elbow function, though it still augmented overall upper extremity function.
• The degree of shoulder improvement correlated with the patient's preoperative residual shoulder function.

Clinical relevance

The findings suggest that staged reconstructive procedures, particularly flexor-pronator transfer for elbow flexion, can be a feasible and effective secondary option even in neglected, severe cases of obstetric brachial plexus palsy, though careful patient selection for each procedure appears important for success.

Who should care