A NARRATIVE REVIEW ON ORTHOTIC APPROACHES IN THE TREATMENT OF BRACHIAL PLEXUS BIRTH PALSY

Purpose: This narrative review synthesized recent evidence on orthotic interventions for brachial plexus birth palsy (BPBP), focusing on indications, timing, and wear schedules. Methods: We searched for English-language articles (published 2004-2025) in PubMed, Scopus, Web of Science, ProQuest, and Google Scholar using "brachial plexus birth palsy" combined with orthosis-related terms. Thirteen studies met inclusion criteria. Results: Early shoulder abduction-external rotation and elbow flexion positioning orthoses improved joint alignment and reduced contracture risk in infants. In older children, static-progressive or dynamic braces corrected established elbow contractures. Caregiver education and adherence influenced outcomes. Wear schedules ranged from a few hours daily for dynamic daytime bracing to near-continuous early positioning. Overall study quality was low and outcome measures varied. Conclusion: Current evidence is limited, but early shoulder abduction-external rotation and elbow positioning orthoses appear beneficial in BPBP. Later static or dynamic braces complement surgery or rehabilitation for residual contractures. High-quality research is needed to establish standardized protocols and determine optimal orthosis type, timing, and duration for each severity level.