152. Sequelae of Deformity in Adults With Brachial Plexus Birth Injuries

PURPOSE: Brachial plexus birth injuries (BPBI) occur in approximately 1 in 1,000 live births. While some recover full function spontaneously, others have residual deficits, leading to various deformities in adulthood. These sequelae impair function and impact the patient’s well-being and quality of life. The purpose of this study is to provide further insight into the sequelae associated with adult BPBI patients. METHODS: Adult patients with BPBI were identified from a multidisciplinary brachial plexus clinic conducted between 2005 and 2023. Patients under 18 years old at index evaluation were excluded. Patient demographics, including type of brachial plexus injury, deformity sequelae, range of motion in shoulder, elbow, forearm, and hand, and pain levels were assessed. RESULTS:43 patients were identified of which 19 were male. The average age was 27(18-61). An upper trunk injury was present in 21 of the patients (49%), while 8 patients (19%) had both upper trunk and intermediate trunk injuries, and 14 patients (33%) had pan plexal injuries. The main reasons for visiting the brachial plexus clinic were pain(n=12), lack of function (n=32) or contracture (n=9). Limb length inequality was the most prevalent deformity, observed in 21 patients (49%). Other common sequelae included elbow flexion contracture and internal rotation contracture. No active external rotation was noted in 23 patients (53%). The mean elbow range of motion was 98. (range 65 to 140) Furthermore, the mean active forearm pronation was 53 degrees in range of motion and the mean active forearm supination was 36. Good hand function was reported in 20 patients, while 19 patients reported a limited to poor hand function. Residual pain was noted in 17 of the patients (37%). CONCLUSION: The sequelae of BPBI as adults remain problematic with functional residual deformities. Many of these patients had been dismissed from their BPBI clinics as they aged over 18 years, despite residual deformities and limited function, highlighting the long-term impact on function and quality of life.