🤱 Chapter 753 · Birth Brachial Plexus Palsy

Nelson Textbook of Pediatrics 22nd Edition | Birth Brachial Plexus Palsy (BBPP): Erb palsy (C5-C6), extended Erb (C5-C7), Klumpke (C8-T1, rare). Narakas classification. Nerve injuries: neurapraxia, axonotmesis, neurotmesis. Early PT, surgical nerve transfer/graft if no biceps by 3-6 months. Secondary procedures for residual deficits.

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📋 30 Clinical Scenarios — Birth Brachial Plexus Palsy

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Brachial Plexus Palsy

Select a newborn arm weakness presentation to review diagnosis and management (Nelson Ch 753).

📋 Stepwise Management of Birth Brachial Plexus Palsy

🔑 Key Principles — Chapter 753
• Narakas classification: I (C5-C6 Erb), II (C5-C7 extended Erb), III (C5-T1 complete), IV (+Horner syndrome).
• Early management: PT/OT starting at 2 weeks, passive ROM, parent education to maintain awareness of affected arm.
• Surgical indications: No antigravity elbow flexion by 3-6 months (Narakas III/IV earlier) or failed conservative therapy. Nerve transfer/graft.
• Secondary surgeries: Tendon transfers (latissimus dorsi), derotational humeral osteotomy for glenohumeral dysplasia.

    ⚡ Reflex Prompts — BBPP Clinical Decisions

    📖 Summary: Birth Brachial Plexus Palsy (Nelson 753)