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In order tizanidine to prevent contractures, passive movements of the paralyzed hand are carried out.

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ConsThe ervative treatment of obstetric paralysis in most patients gives quite satisfactory results, but in some cases it is necessary to resort to surgical interventions. Of the surgical methods, first of all, we should mention operations on the brachial plexus, in order to free the nerves from the scars and restore the anatomical integrity of the roots. They, as well as other surgical interventions, should be applied only after all available means of conservative therapy have been used.

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What follows are various methods of muscle transplantation in order to replace the function of the paralyzed; these include: Moore's operation for Erb's palsy to improve the function of the deltoid muscle, while a part of the preserved anterior portion of this muscle is transplanted along with the outer edge of the acromial process posteriorly to the scapular spine. Transection of the tendon of the subscapularis muscle along the North. transplant m. subscapularis on tendon m. teres minor.

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Muscle transplantation is indicated only when the muscle to be transplanted has sufficient strength, otherwise it is useless. As a result, muscle plasty in birth paralysis is not widely used, due to the limited possibility of using muscles suitable for transplantation due to the prevalence of paralysis in severe cases. With complete paralysis of the deltoid muscle and good function of the muscles of the shoulder girdle, arthrodesis of the shoulder joint is more promising in terms of functional results than muscle plastic surgery. The purpose of the arthrodesis operation is to fuse the humerus with the scapula, to ensure active abduction of the shoulder due to the movements of the scapula. After a successful operation, patients in a short time begin to move their arm, raising it to the level of the shoulder girdle.

Particularly good results are obtained in cases where the muscles of the shoulder and forearm are not affected, but even in cases of paralysis of all the muscles of the arm, due to the restoration of shoulder movements, the working capacity of the entire previously helplessly hanging arm improves: the patient is able to hold objects by clamping them between the shoulder and torso, hold paper, notebook while writing, press the ruler when drawing.

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With paresis of the muscles of the shoulder and forearm after arthrodesis of the shoulder joint, along with an improvement in the function of the arm, the strength of the paretic muscles increases, in connection with this, children begin to gradually master self-care skills (combing their hair, dressing themselves, etc.).
For a successful operation, it is necessary to carefully remove the cartilaginous cover from the arthrodesis surfaces of the head of the humerus and the glenoid cavity of the scapula, to ensure close contact and strong retention in the given position.
The latter is achieved by driving a nail through the head of the humerus into the articular cavity of the scapula or through the acromial process of the scapula, the lower surface of which is preliminarily refreshed.

After removing the plaster cast, it is advisable to wear a hand on a wedge-shaped pillow for 2-3 months, gradually reducing its thickness. At this time, treatment is carried out with massage and gymnastics.
The prognosis for obstetric paralysis of the upper limb depends on the nature and severity of damage to the nerves or their roots, on the time elapsed since the injury, on the presence of secondary contractures.

Fortunately, milder injuries are more common and usually respond quickly to conservative treatment. At the same time, these mild cases do not differ in any way from cases that lead children to disability, so the prognosis is made with caution. Persistent pupillary irregularity indicates a poor prognosis.
Preventive measures for obstetric paralysis should be aimed primarily at familiarizing persons involved in obstetric care (midwives) with complications during childbirth in the form of fractures, dislocations and paralysis resulting from the use of excessive physical force and improper methods during obstetric care.

Further preventive measures are reduced to early detection of obstetric paralysis and early treatment. To this end, it is necessary to train the staff of maternity hospitals and maternity wards of hospitals (pediatricians, obstetricians) in the early diagnosis of injuries, in particular paralysis.
Children suffering from obstetric paralysis should be registered for further follow-up and treatment.