Parálisis obstétrica del plexo braquial. Revisión del estado actual de la enfermedad

Enrique Manuel Vergara-Amador

doi:10.15446/revfacmed.v62n2.45416

Publicado

2014-04-01

Parálisis obstétrica del plexo braquial. Revisión del estado actual de la enfermedad

Current concepts concerning obstetric brachial plexus palsy

DOI:

https://doi.org/10.15446/revfacmed.v62n2.45416

Palabras clave:

Plexo Braquial, Parálisis Obstétrica, Neuropatías del Plexo Braquial, Traumatismos del Nacimiento (es)
Brachial Plexus, Paralysis, Obstetric, Brachial Plexus Neuropathies, Birth Injuries (en)

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Autores/as

Enrique Manuel Vergara-Amador Unidad de Ortopedia. Facultad de Medicina. Universidad Nacional de Colombia. Bogotá,Colombia.

Resumen (es)
Resumen (en)

El presente documento hace una revisión actual de la parálisis obstétrica del plexo braquial; se observan la etiología, aspectos demográficos, diagnóstico, cuándo deben ser observada sin cirugía y cuándo es el momento de operar. La clave de indicación de cirugía está dada cuando no ha habido recuperación del bíceps contra gravedad entre los tres y seis meses de edad. La cirugía está dirigida a la resección del neuroma y la utilización de injertos nerviosos. También tiene cabida en el tratamiento quirúrgico el uso de las transferencias nerviosas o neurotizaciones. La recuperación es lenta y se observaran resultados hasta los dos o tres años después de la cirugía. En los niños mayores de 18 meses, el tratamiento se enfoca, no en la microcirugía, sino en la reconstrucción mediante liberaciones, transferencias tendinosas y osteotomías.

This article presents a review of current concepts in obstetric brachial plexus palsy (OBPP) looking at its aetiology, demographic aspects, diagnosis and when patients should be observed without surgery and when it is time to operate. Surgery is indicated when there has been no recovery of biceps against gravity (active elbow flexion) against gravity between 3 to 6 months of age. Surgery is focused on neuroma resection and the use of nerve grafts. Nerve transfer or neurotisation also has a place in surgical treatment. Recovery is slow and results are usually observed 2 to 3 years after surgery. Treatment in children aged over 18 months will not consist of microsurgery reconstruction but rather tendon transfer, release and osteotomy.

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