Summary
Background
Brachial plexus injury diagnosed following delivery often causes lifelong disability
and frequently results in litigation. While there is no universally accepted name
for this condition, the term ‘obstetrical brachial plexus palsy’ (OBPP) is commonly
used worldwide. The difficulty with the term ‘OBPP’ lies with the use of the word
‘obstetrical’, which some have construed to imply obstetrical malpractice even if
none occurred. Many regions, especially in the United States, are suffering increasing
obstetrician shortages, sometimes as a result of unsustainable liability insurance
premiums. We wanted to determine whether surgeons felt that an alternative to the
term ‘OBPP’ was more appropriate.
Methods
We surveyed peripheral nerve surgeons worldwide to determine the appropriateness of
the term ‘OBPP’ and alternative terms.
Results
The majority of US-based surgeons (94%) preferred alternative terms, such as ‘neonatal
brachial plexus palsy’. However, only 53% of surgeons from other regions preferred
alternative terms. This difference was statistically significant (p < 0.0002).
Conclusions
More precise and descriptive alternatives to the term ‘OBPP’ are available and acceptable
to many surgeons. An alternative to ‘OBPP’ may improve communication between practitioners,
families and the legal system, especially in the United States. Our peripheral nerve
organisations may be able to provide further leadership on this matter.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Causes of neonatal brachial plexus palsy.Bull NYU Hosp Jt Dis. 2011; 69: 11-16
- Obstetrical brachial plexus injury in newborn babies delivered by caesarean section.J Hand Surg (Edinburgh, Scotland). 1996; 21: 263-265
- Obstetrical brachial plexus palsy.Plast Reconstr Surg. Jul 2009; 124: 144e-155e
- Perinatal brachial plexus palsy.Curr Opin Pediatr. 2000; 12: 40-47
- Brachial plexus palsy: an in utero injury?.Am J Obstet Gynecol. 1999; 180: 1303-1307
- Erb's palsy after delivery by cesarean section. (A medico-legal key to a vexing problem.).Med Law. 2005; 24: 655-661
- Malpractice premiums and the supply of obstetricians.Inquiry. 2010; 47 (A Journal of Medical Care Organization, Provision and Financing): 48-61
- Birth brachial plexus injury is the preferred terminology.J Hand Surg. 2006; 31: 203
Article info
Publication history
Published online: April 18, 2012
Accepted:
March 26,
2012
Received:
December 9,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
