Obstetric plexitis refers to birth trauma and represents damage to the shoulder joint. Occurs in 2 out of 1,000 newborns, mainly with prolonged, prolonged labor, which were accompanied by artificial interference.
How and when does it happen?
Plexitis of the shoulder joint in newborns is formed because of its incorrect position in the uterus, because of which delivery is difficult or impossible. In this case, the obstetrician releases the handle of the fetus and extracts it at the head end with forceps. As a result, the overgrowth of the brachial plexus occurs due to the deviation of the head by the obstetrician in one or the other direction.
As a rule, we can not single out only one reason for the birth paralysis, since there is an excessive stretching of the nerves together with their pressing to the bone formations in the process of childbirth.
Also, generic plexitis can occur as a result of tipping the fruit handle up, behind the back of the head. As a result, simultaneously with the stretching of the nervous brachial plexus, compression occurs between the head of the shoulder, the clavicle and the transverse processes of the lower vertebrae of the cervical spine.
If, however, the fetus leaves two shoulders at the time of delivery, the plexitis in the newborn occurs as a result of compression of the brachial plexus with the clavicle and humerus. This type of birth injury occurs 3 times more often with headache than with the gluteal.
In medical practice, there are 3 types of plexitis of the shoulder joint, which differ among themselves in that different parts of the brachial plexus are affected.
Symptoms
Plexitis of the shoulder joint, observed in newborns, has rather well-marked symptoms. The classic sign of this disease is that the handle lies motionless near the trunk, and the shoulder is rotated (turned) inwards. The forearm is unbent. The palm is facing upwards. With painful stimulation of this arm, there is no response motor reaction. Passive movement of the hand is carried out freely. In the case when both the passive and active limb movements are hampered, one can assume the development of the so-called pseudo-paralysis of the newborn's hand. It occurs due to fracture of the humerus or epiphyolysis of the shoulder. Pseudo-paralysis is rare.
In the plexitis of the shoulder joint, it is especially striking that in the damaged arm there is a significant decrease in the tone of muscle musculature.
Treatment
Treatment of plexitis in newborns is conducted in the same way as in adults. Begin it from the first weeks of the baby's life. Children who have already reached the age of one year are undergoing a restorative treatment.
Untimely treatment of such a disease can lead to the development of contractures. In this case, the only solution will be surgical intervention.
Treatment of plexitis of the shoulder joint is a long process. It usually includes:
- therapeutic gymnastics;
- electrostimulation;
- drug electrophoresis;
- heat treatment (paraffin baths).
Also, with plexitis, massage is shown. Children aged more than 3 years often carry out interference therapy of the brachial plexus. To do this, 1 electrode is placed on the brachial plexus, and the second - on the wrist. In total, up to 10-12 such procedures are carried out.
Active treatment of shoulder plexitis is performed in children in the first 5-7 years of life.
Thus, the plexitis of the shoulder joint is a rather complex disease, which requires complex and long-term treatment.