Brachial plexus palsy in the newborn. Incidence and prognosis.

The problem of the accuracy of current data regarding prognosis of brachial plexus palsy in the newborn infant was studied by means of a retrospective review of hospital records, letters to parents of affected infants, and follow-up examinations of available children. Only 11 cases of mild upper plexus injuries were found in a review of 19,314 newborn infants' charts, an incidence of 0.57 per 1,000 live births. Four cases were available for examination and 4 others were evaluated from follow-up records. Three were lost to follow-up. No instance of permanent paralysis was found, thus raising the possibility that while permanent paralysis is still seen, it may now represent a diminishing minority of the total, at least in the United States with modern obstetrical care. This is in contrast to the opinion one might formulate from a review of the orthopedic literature on this subject.