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Title: Sensibility of the Hand in Children With Conservatively or Surgically Treated Upper Neonatal Brachial Plexus Lesion.
Author: Buitenhuis SM, Pondaag W, Wolterbeek R, Malessy MJA.
Journal: Pediatr Neurol; 2018 Sep; 86():57-62. PubMed ID: 30077550.
Abstract:
BACKGROUND: The aim of this study was to assess the sensibility of the hand in children with a neonatal brachial plexus palsy (NBPP) involving the C5 and C6, and to correlate results with dexterity. METHODS: Fifty children with NBPP (30 after nerve surgery, mean age 9.8 years) and 25 healthy controls (mean age 9.6 years) were investigated. Sensibility was assessed with two-point discrimination and Semmes-Weinstein monofilaments. Dexterity was evaluated with a single item from the Movement Assessment Battery for Children-2. We compared the affected side with the nondominant hand of the control group. RESULTS: The sensibility in the first and second fingers was significantly diminished in the NBPP for both two-point discrimination (P = 0.005 and P = 0.014, respectively) and monofilament test (P < 0.001). Dexterity was significantly lower in the NBPP group than in control group, corrected for age (P = 0.023). There was a significant difference toward decreasing hand function with decreasing sensibility according to the Semmes-Weinstein test for the thumb (Jonckheere-Terpstra nonparametric trend test, P = 0.036). CONCLUSIONS: The sensibility of the thumb and index finger in children with an upper plexus lesion (either surgically or conservatively treated) is diminished. The decreased sensibility has a negative impact on hand function. Appreciation of diminished hand function in patients with NBPP involving C5 and C6 is important to optimize treatment.

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