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SYSTEMATIC REVIEW article

Front. Surg.
Sec. Orthopedic Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1359719

Global Trends in Surgical Approach to Neonatal Brachial Plexus Palsy: A Systematic

Provisionally accepted
Michael F Levidy Michael F Levidy 1Amanda Azer Amanda Azer 1*Jasmine Shafei Jasmine Shafei 1Nivetha Srinivasan Nivetha Srinivasan 1Jasmine Mahajan Jasmine Mahajan 1Shivani Gupta Shivani Gupta 1George Abdelmalek George Abdelmalek 1Krittika Pant Krittika Pant 1Kunj Jain Kunj Jain 1Yash Shah Yash Shah 1Zheshi Zheng Zheshi Zheng 2Johnny Chuieng-Yi Lu Johnny Chuieng-Yi Lu 3Tommy Nai-Jen Chang Tommy Nai-Jen Chang 3Aleksandra McGrath Aleksandra McGrath 4,5Alice Chu Alice Chu 1,6
  • 1 New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
  • 2 Rutgers University, Newark, Newark, New Jersey, United States
  • 3 Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taipei County, Taiwan
  • 4 Umeå University, Umeå, Västerbotten, Sweden
  • 5 Department of Clinical Science, Faculty of Medicine, Umeå University, Umeå, Västerbotten, Sweden
  • 6 Department of Orthopaedics, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States

The final, formatted version of the article will be published soon.

    Background: We analyzed trends in age at surgery and surgical approach over time and geography.Methods: We performed a systematic review according PRISMA-IPD guidelines to include individual patient data. Collected data included: age at surgery, location of surgery, and surgical approach. Surgical approach was independently categorized as: exploration of the brachial plexus (EBP) or nerve transfer without root exploration (NTwoRE). EBP was defined as exploring brachial plexus in the supraclavicular fossa and applying a choice of coaptation procedures. NTwoRE included those sourcing donor nerves from, or entirely occurring outside of the plexus without exploring the root of brachial plexus.Results: Regression analysis of age at surgery 1985-2020 showed that age at BPBI surgery is rising. (p<.05) Surgery was performed at a younger age in patients from Europe (7.06 ± 7.77 months) and Asia (7.58 ± 5.33 months) than those from North America (10.44 ± 5.01 months) and South America (14.71 ± 4.53 months). (p<0.05). NTwoRE were more common in North America (37%) and least common in Europe (12%). Age at EBP was 7.2 ± 5.77 months; age at NTwoRE was 15.85 ± 13.18 months. (p < .05) incidence of NTwoRE is increasing time.Conclusions: Age at NBPP surgery is increasing over time. Regional differences exist in age at NBPP surgery. Approaches to NBPP surgery that avoid exploration of BP roots are becoming more popular. Age at EBP is lower than age at NTwoRE.

    Keywords: Brachial Plexus, Neonatal brachial palsy, Trends, Nerve Transfer, Nerve exploration

    Received: 21 Dec 2023; Accepted: 20 Jun 2024.

    Copyright: © 2024 Levidy, Azer, Shafei, Srinivasan, Mahajan, Gupta, Abdelmalek, Pant, Jain, Shah, Zheng, Chuieng-Yi Lu, Chang, McGrath and Chu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Amanda Azer, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, 07103, New Jersey, United States

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