Strain or compression of the fetal brachial plexus nerve during delivery is the main cause of brachial plexus injury in newborns, most commonly to the upper brachial plexus trunk. If an infant is born with asymmetrical movements or dysfunction of the upper extremities (from the shoulder to the fingers), such as inability to abduct and lift the shoulder joint, inability to flex the elbow joint but can extend it, and inability to flex the wrist joint but with reduced muscle strength, it should be considered a neonatal brachial plexus injury (i.e., birth palsy). Because brachial plexus injury is often combined with peribrachial plexus hemorrhage and finally adhesion scarring, if early treatment can prevent adhesions and prevent scarring, and can stimulate peripheral nerve recovery as soon as possible. Therefore, for neonatal brachial plexus injury, passive observation is better than early treatment, the earlier the treatment, the less scar formation, therefore, early rehabilitation is advocated. If there is no significant recovery in clinical examination and electromyography after 3 months to 6 months of conservative rehabilitation, surgical treatment can be considered: brachial plexus nerve exploration, release, and late line functional reconstruction by nerve grafting.
Early application of neurotrophic drugs, such as: rat nerve growth factor, cytodiphosphorylcholine and other intravenous drugs to restore nerve cells, in a course of treatment, generally ten days as a course of treatment. Protection of sensory loss: The damaged limb is vulnerable to further bruises or burns, and it is more difficult to repair skin damage after loss of innervation, so it is necessary to protect the skin innervated by loss of nerve hair and avoid scalding and pressure injuries. Care of swelling: the brachial plexus injury limb muscle loss of motor function also lost to the limb when the venous squeeze reflux role, especially when the limb is in a downward position and joint extreme flexion position swelling more obvious, to often carry out passive muscle activity and change the joint position, appropriate elevation of the affected limb with warm water hot compresses, passive stretching should be slow, the range should be ashamed to increase, do not rough, so as not to cause new injuries. After 3 months of conservative treatment, surgery can be considered if there is no improvement in the shoulder and elbow joint.