PRELIMINARY STUDY OF OBSTETRIC PARALYSIS OF THE BRACHIAL PLEXUS AT THE NATIONAL CENTRE FOR DISABLED PERSONS IN YAOUNDE, CAMEROON, ABOUT A COHORT OF 15 CASES: FREQUENCY, PHYSIOTHERAPY TECHNIQUES AND SHORT-TERM RESULTS OF CONSERVATIVE TREATMENT IN A RESOURCE-LIMITED COUNTRY

Background: Neonatal brachial plexus palsis (NBPP) is a childbirth-related trauma whose frequency, risk factors, clinical forms and outcomes of physiotherapy techniques that can be used in our context are not known. Method: This cohort study took place from June 1 to August 30, 2016. The incidence was determined at the Main Maternity Hospital of the Central Hospital of Yaounde. The cohort of patients selected was evaluated at the National Centre for the Rehabilitation of Disabled Persons before and after physiotherapy. The physiotherapy techniques used were identical, 3 times a week for 3 months, for all children: stimulation, mobilization, immobilization, in addition to home exercises. Results: The incidence of NBPP was 3%. The most frequent risk factors in the 15 cases were: low maternal socio-educational level (73.33%), low parity (53.33%), childbirth in a peripheral health facility (60%), weight gain over 15 kilograms during pregnancy (73.33%) and macrosomia (73.33%). We had 15 NBPPs, 73.33% on the leftt upper arm and 60% in girls. The average age of the children was 29.93[2-182] weeks. The mothers average age was 29.33[19-35] years at the time of birth. The proximal forms or the Erb type (80%), were the most represented followed by the total forms ( 20%). Torontos average score before and after physiotherapy increased from 5.66[1-11] to 9.66[3-16] out of 21. We had 10 (66.66%) improvements, in the short term concerning the proximal forms. Conclusions: We had some good results with physiotherapy techniques applicables in developping countries for the Erb palsy which is the most frequent NBPP. This is why we recommend physiotherapy first and surgery if failure after 3 months, if larger studies confirm our data