Obstetrical brachial palsy

Obstetrical brachial palsy (OBP) (also known in its various forms as Erb's palsy, Klumpke's paralysis, Erb-Duchenne palsy) complicates a very small proportion of births. Furthermore it seems likely that many cases recover with little in the way of remaining deficit but it is equally certain that some cases will not recover. There is increasing evidence that microsurgical help at an early stage can improve the prognosis in some cases. Scepticism exists about the role of surgery and many cases are referred too late for primary nerve surgery. Specialist surgical advice, specialist physiotherapy and where appropriate, either early nerve surgery or secondary reconstructive procedures at a later date can improve the condition of many of these children. This review condenses many of the current opinions and highlights areas of developing knowledge and debate.