Affiliations: Department of Neurosurgery, Leiden University Medical
Center, Leiden, The Netherlands
Note:  Corresponding author: Martijn Malessy, MD, PhD., Department of
Neurosurgery, Leiden University Medical Center, POB 9600, 2300 RC Leiden, The
Netherlands. Tel.: +31 71 5263957; Fax: +31 71 5248221; E-mail:
Abstract: Neonatal brachial plexus palsies may cause lifelong limitations to
function of the upper limb. Early nerve reconstructive surgery may be indicated
in selected cases. An overview is given of our current understanding of this
type of nerve lesion in the developing child. The neuropathology of the injury
is presented to provide a background for the understanding of its natural
history, as well as for the rationale and methods for nerve surgical treatment.
The assessment of upper limb function and the range of severity of the lesions
at the very young age are outlined. Decision-making regarding surgical
selection and determination of the appropriate procedures is presented, as are
the outcomes. Improved function can be obtained with surgical repair.
Keywords: Neonatal brachial plexus palsy, nerve surgery