SVIBOR - Project code: 3-01-054

MINISTRY OF SCIENCE AND TECHNOLOGY

Strossmayerov trg 4, HR - 10000 ZAGREB
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Project code: 3-01-054


BRACHIAL PARALYSIS AND ASSOCIATED FINDINGS


Main researcher: STOJČEVIĆ-POLOVINA, MILENA (97491)


Assistants
Type of research: applied
Duration from: 04/30/91. to 12/31/94.
Papers on project (total): 0
Institution name: Medicinski fakultet, Zagreb (108)
Department/Institute: a
Address: Vinogradska 29
City: 10000 - Zagreb, Croatia
Communication
Summary: In polyvalent rehabilitation of children, parlysis of an armform lesion of the brachial plexus presents complex problems,because of the large spectrum of possible impairments andassociated findings, on the one hand, and the scope as well aslong duration of the rehabilitation treatment, on the other hand.To cope with these problems, the dynamics of the development ofmotorium in children should be thoroughly understood. To this end, the ideal motorial development from the proneand upine position at birth until the acquirement of independentbipedal locomotion was studied. Special attention was paid to thestudy of positional reflexes, in order to evaluate the children'smaturity, make proper diagnosis of their development and identifytheir motorial problems. When analyzing the possible causes of the lesins of thebrachial plexus, risk factors were found in most childrenand among them the perinatal risk factors were dominat. Theleading risk factor was high weight at birth, folowed byasphyxia, vacuum extraction delivery and breech delivery. Theseperinatal causes of paralysis were accompanied by lesions of theCNS, injuries to the osteomuscular apparatus, peripheral nervesand soft partes. Detection of risk factors constitutes a significantcontribution to primary prevention. An epidemiological study wascarried out to detect intrapartum traumas visible at birth in6.234 newborn infants.In 4.5% of them traumas were found: 97% ofthese were single and 3% double intrapartum traumas, mostfrequently unilateral ones. Fractures of the clavicle were foundin 3.6% of infants, tortcollis in 0.48%, paresis of the brachialplexus in 0.19% and fractures of the humerus in 0.03% of them.Lesions of the brachial plexus are the most difficultrehabilitation problem,because their treatment is long-lastingand complete cure is achieved in about 40% of cases. As theanticipated number of brachial paralysis in this country is 3.4per 1000 liveborn infants, this lesion is a major therapeuticalproblem. The second major therapeutical problem is torticollis,however, proper rehabilitation treatmen of this lesions givesquite satisfactory results. Fracture of the humerus is a lesserproblem, its treatment is of short duration and the results aregood.Fracture of the clavicle needs no special treatment, onlyobservation and care. Children with lesion of the bracihial plexus have beensystematically studied to gain a better insight into itsetiopathogenesis and learn more about its therapy, i. e. tosynthesize scientific observations and facts to improve thehealth care of these children.

Keywords: Brachial plexus paresis, accompanying findings, risk factors, rehabilitation

Research goals: The aim of the study was to investigate children with brchial paralysis to determinate the extent and severity of the lesion and detect the presence of associated findings and possible causes of paralysis. The final goal was improvment of the primary and secondary prevention. The anticipated results, i.e. scientific contribution of the study, lies in the systematic analysis of the complexity of the problem of brachial paralysis in children from the moment of diagnosis and retrograde analysis of pregnancy and delivery until maximal possible restoration of health, and consists of: -becoming acquainted with the spectrum of risk factors -establishing the most common risk factors -establishing possible relationship between single and complex risk factors and the lesions of the brachial plexusas well as the spectrum of associated findings -gaining more insight into the pathogenesis of intrapartum traumas -advancement ofprimary prevention -establishing the significance of timely rehabilitation of the lesion of the brachial plexus -finding optimal therapeutic procedurs -evaluating the results of the rehabilitation tratment -acquiring new scientific knowledge and harmonizing knowledge, available facilities and needs for advancement of work -improving secondary prevention -restoring children with retarted motorial development to self-sufficience and independent life and work -explotation of the results of this study in obstetrics, neonatology,neurology, psychology, rehabilitation science, social medicine and education -obtaining data relevant to the problem studied; theoretical, practical or even merely computed mathematical data -publishing the obtained results to make them avaiable to the scientific public in this country and abroad.

COOPERATION - INSTITUTIONS


  1. Name of institution: Klinika za djecje bolesti Klinicke bolnice "Sestre milosrdnice"
    Type of institution: International organization
    City: 10000 - Zagreb, Croatia

  2. Name of institution: Klinika za zenske bolesti i porođaje Klinicke bolnice "Sestre milosrdnice"
    Type of institution: International organization
    City: 10000 - Zagreb, Croatia

  3. Name of institution: Klinika za djecje bolesti KBC Rebro
    Type of institution: International organization
    City: 10000 - Zagreb, Croatia

  4. Name of institution: Klinika za djecje bolesti Zagreb
    Type of institution: International organization
    City: 10000 - Zagreb, Croatia
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