Nerve Graft and Nerve Transfer for Improving Elbow Flexion in Children with Obstetric Palsy. A Systematic Review^[*]

Abstract

Obstetric brachial plexus palsy is a rather common injury in newborns, caused by traction to the brachial plexus during labor. In this context, with the present systematic review, we aimed to explore the use of nerve graft and nerve transfer as procedures to improve elbow flexion in children with obstetric palsy. For the present review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the MEDLINE, EMBASE, LILACS, The Cochrane Central Register of Controlled Trials, Web of Science, Wholis and SCOPUS databases. Predetermined criteria defined the following requirements for inclusion of a study: Clinical trials, quasi-experiments, and cohort studies that performed nerve graft and nerve transfer in children (≤ 3 years old) with diagnosis of obstetric palsy. The risk of bias in nonrandomized studies of interventions assessment tool was used for nonrandomized studies. Out of seven studies that used both procedures, three of them compared the procedures of nerve graft with nerve transfer, and the other four combined them as a reconstructive method for children with obstetric palsy. According to the Medical Research Council grading system, both methods improved equally elbow flexion in the children. Overall, our results showed that both techniques of nerve graft and nerve transfer are equally good options for nerve reconstruction in cases of obstetric palsy. More studies approaching nerve reconstruction techniques in obstetric palsy should be made, preferably randomized clinical trials, to validate the results of the present systematic review.

Keywords

obstetrical brachial plexus palsy - nerve transfer - allogenic grafts

Authors Contributions

Girón E. V. and Zapata-Copete J. A. contributed substantially to the conception, design of the work, acquisition, analysis, and interpretation of data for the work. Girón E. V. and Zapata-Copete J. A. contributed to the drafting of the work and revised it critically for important intellectual content. Girón E. V. and Zapata-Copete J. A. approved the final version to be published. Girón E. V. and Zapata-Copete J. A. agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or to the integrity of any part of the work are appropriately investigated and resolved.

^* Work developed at the Orthopedic Hand Surgery Section, Department of Surgery, Universidad del Valle, Cali, Colombia.

Publikationsverlauf

Eingereicht: 31. August 2020

Angenommen: 17. Dezember 2020

Artikel online veröffentlicht:
13. August 2021

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