Background: Prior investigators have demonstrated the effectiveness of brachial plexus reconstructive surgery in neonates with obstetrical brachial plexus palsy. In the present study, we compared limb growth in a group of neonates underwent surgery with those who were subjected for surgery but refused. Material and methods: Totally, 55 neonates received treatment during a 10-year period were selected. They were assigned in 2 groups: 25 who could not achieve biceps flexion during the first 3 months and underwent reconstructive surgery (case group), and 30 neonates who had been subjected for reconstructive surgery but refused (control). Finally, the intact and the injured limb were measured from acromion to the third finger. Results: C5, C6, and C7 were the most common affected sites, while, nerve graft was the most common microscopic surgical approach. Limb shortening was 0-3 cm in operated as compared to 3-25cm in non-operated neonates (p<0.05). Conclusion: Neonates who could not achieve biceps flexion during the first 3 months should be scheduled for reconstructive surgery, mainly with nerve grafting.

Keywords: Obstetrical palsy, Brachial plexus, Limb shortening

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