Objective: Search for operation timing and methods for obstetrical brachial plexus injury(OBPI). Methods: Thirty-two children with upper OBPI were treated by microsurgical procedure from October 1997 through April 2001, The average time of operation is 10 months of age, ranged from 3 months to 24 months, of which 19 were below 6 months while 13 were over 6 months. Surgical procedure included neurolysis (n=11), coaption after resection of the neroma without function(n=6), phrenic nerve transfer to anterior cord of upper trunkor musculocutaneous nerve (n=7) and intercostal nerves transfer to musculocutaneous nerve (n=6). The children were underwent operation by microsurgical technique and 7–0 or 9–0 nylon were used for nerve suture. Results: Thirty cases were followed-up 21 months postoperatively, the excellent and good rate is 76.7%(23/30). The results of the children under 6 months is better than that over 6 months . Conclusions: We concluded that the microsurgical operation might be considered at 3 to 6 months of age in infants who have shown little or no improvement in elbow flexion . Patients undergoing neurolysis and nerve coaption had more favorable outcome than those undergoing neurotization. The appropriate procedure must be selected according to the findings of exploration.
