Article

AIM: To give an overview of indications for the use of botulinum toxin A (BoNT-A)
treatment for children with obstetric brachial plexus injury (OBPI), and to
present the best available evidence of the effectiveness of this treatment.
METHOD: Searches were performed in Cinahl, Cochrane Library, Embase, PubMed, and
Web of Science, using the keywords 'botulinum' and 'plexus', to identify articles
reporting on the use of BoNT-A as a treatment for children with OBPI. Studies
found through the references of related articles were also selected. RESULTS: Ten
full-text papers and six congress abstracts were included, involving 343
children. Four groups of indications could be identified: internal
rotation/adduction contracture of the shoulder, limited active elbow flexion,
limited active elbow extension, and pronation contracture of the lower arm.
Overall, positive results were reported for all except the indication for limited
active elbow extension. However, only one study was comparative in nature; all
others were classified as having a low level of evidence. There was a large
variation in outcome measures. INTERPRETATION: To provide better evidence for the
already partly promising results of BoNT-A treatment for children with OBPI,
multicentre randomized controlled trials are needed.

Langue : ANGLAIS