{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T10:12:26Z","timestamp":1788603146578,"version":"build-2803163510"},"reference-count":62,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2027,1,1]],"date-time":"2027-01-01T00:00:00Z","timestamp":1798761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2027,1,1]],"date-time":"2027-01-01T00:00:00Z","timestamp":1798761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jhsgo.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hand Surgery Global Online"],"published-print":{"date-parts":[[2027,1]]},"DOI":"10.1016\/j.jhsg.2026.101112","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:38:37Z","timestamp":1788601117000},"page":"101112","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revisiting the Original Narakas Classification of Brachial Plexus Birth Injuries"],"prefix":"10.1016","volume":"9","author":[{"given":"Victoria","family":"Robbins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan A.","family":"Zlotolow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Meisel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7690-2401","authenticated-orcid":false,"given":"Steven M.","family":"Koehler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.jhsg.2026.101112_bib1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/1753193420934676","article-title":"Evidence that nerve surgery improves functional outcome for obstetric brachial plexus injury","volume":"46","author":"Pondaag","year":"2020","journal-title":"J Hand Surg (Eur Vol)"},{"issue":"2","key":"10.1016\/j.jhsg.2026.101112_bib2","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/j.1469-8749.2004.tb00463.x","article-title":"Natural history of obstetric brachial plexus palsy: a systematic review","volume":"46","author":"Pondaag","year":"2004","journal-title":"Dev Med Child Neurol"},{"issue":"2","key":"10.1016\/j.jhsg.2026.101112_bib3","doi-asserted-by":"crossref","first-page":"225e","DOI":"10.1097\/PRS.0000000000012041","article-title":"Redefining the incidence of infantile glenohumeral dysplasia following brachial plexus birth injury","volume":"156","author":"Khabyeh-Hasbani","year":"2025","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jhsg.2026.101112_bib4","series-title":"The Paralysed Hand","first-page":"116","article-title":"Obstetric brachial plexus injuries","author":"Narakas","year":"1987"},{"issue":"2","key":"10.1016\/j.jhsg.2026.101112_bib5","doi-asserted-by":"crossref","first-page":"222","DOI":"10.3171\/2015.6.PEDS14703","article-title":"Obstetrical brachial plexus injury: burden in a publicly funded, universal healthcare system","volume":"17","author":"Coroneos","year":"2016","journal-title":"J Neurosurg Pediatr"},{"issue":"4","key":"10.1016\/j.jhsg.2026.101112_bib6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/0272684X19883523","article-title":"Role of early referral and surgical intervention in brachial plexus birth palsy: awareness among obstetricians and pediatricians in a teaching hospital","volume":"40","author":"Nayak","year":"2020","journal-title":"Int Q Community Health Educ"},{"issue":"6","key":"10.1016\/j.jhsg.2026.101112_bib7","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.2106\/00004623-196749060-00003","article-title":"Erb's palsy. Long-term results of treatment in eighty-eight cases","volume":"49","author":"Adler","year":"1967","journal-title":"J Bone Joint Surg Am"},{"issue":"6024","key":"10.1016\/j.jhsg.2026.101112_bib8","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1136\/bmj.1.6024.1520","article-title":"Prognosis and early management of birth injuries to the brachial plexus","volume":"1","author":"Bennet","year":"1976","journal-title":"Br Med J"},{"issue":"10","key":"10.1016\/j.jhsg.2026.101112_bib9","first-page":"458","article-title":"Brachial plexus palsy in neonates and children","volume":"59","author":"Eng","year":"1978","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.jhsg.2026.101112_bib10","series-title":"Le Paralisi ostetriche","first-page":"47","article-title":"L\u2019evoluzione naturale della paralisi ostetrica","author":"Guida","year":"1984"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib11","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1302\/0301-620X.63B1.7204481","article-title":"Birth injuries of the brachial plexus: incidence and prognosis","volume":"63-B","author":"Hardy","year":"1981","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.jhsg.2026.101112_bib12","series-title":"Etiopathogenesi ed epidemiologia","first-page":"17","article-title":"Le paralisi ostetriche dell'arto superiore","author":"Letizia","year":"1984"},{"key":"10.1016\/j.jhsg.2026.101112_bib13","series-title":"To Illustrate His Former Treatise, or First Volume, on That Subject. Vol 2","first-page":"448","article-title":"A Collection of Cases and Observations in Midwifery","author":"Smellie","year":"1768"},{"key":"10.1016\/j.jhsg.2026.101112_bib14","first-page":"82","article-title":"Nervous affection in young infants","volume":"25","year":"1844","journal-title":"Dublin J Med Sci"},{"key":"10.1016\/j.jhsg.2026.101112_bib15","first-page":"48","article-title":"Communication d'un cas de paralvsie du membre sup\u00e9rieur","volume":"2","author":"Danyau","year":"1851","journal-title":"Bulletin dela Soci\u00e9t\u00e9 de Chirurgie (Paris)"},{"key":"10.1016\/j.jhsg.2026.101112_bib16","first-page":"348","article-title":"Diagnostic diff\u00e9rentiel des paralysies cerebrales de l'enfance d'avec la paralysie atrophique graisseuse de l'enfance et d'avec certaines paralysies traumatiques cong\u00e9nitales","author":"Duchenne","year":"1861"},{"key":"10.1016\/j.jhsg.2026.101112_bib17","first-page":"130","article-title":"\u00dcber eine eigent\u00fcmliche Lokalisation von L\u00e4hmungen im Plexusbrachialis","volume":"2","author":"Erb","year":"1874","journal-title":"Naturhist Med Verh Heidelberg Verh"},{"key":"10.1016\/j.jhsg.2026.101112_bib18","first-page":"101","article-title":"Geburtstraumatisch totale Plexuslahmung","volume":"20","author":"Seeligmueller","year":"1877","journal-title":"Deutscher Archiv fur Klinische Medezin"},{"key":"10.1016\/j.jhsg.2026.101112_bib19","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1097\/00000441-190510000-00013","article-title":"A study in brachial birth palsy","volume":"130","author":"Clark","year":"1905","journal-title":"Am J Med Sci"},{"issue":"2197","key":"10.1016\/j.jhsg.2026.101112_bib20","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1136\/bmj.1.2197.298","article-title":"Suture of the brachial plexus in birth paralysis of the upper extremity","volume":"1","author":"Kennedy","year":"1903","journal-title":"Br Med J"},{"key":"10.1016\/j.jhsg.2026.101112_bib21","first-page":"494","article-title":"Brachial birth palsy and injuries of similar type in adults","volume":"30","author":"Taylor","year":"1920","journal-title":"Surg Gynecol Obstet"},{"key":"10.1016\/j.jhsg.2026.101112_bib22","first-page":"29","article-title":"The field of neurological surgery in a general hospital","volume":"24","author":"Wyeth","year":"1917","journal-title":"Surg Gynecol Obstet"},{"key":"10.1016\/j.jhsg.2026.101112_bib23","first-page":"1065","article-title":"Further notes on the treatment of birth paralysis of the upper extremity by suture of the fifth and sixth cervical nerves","volume":"2","author":"Kennedy","year":"1904","journal-title":"Br Med J"},{"key":"10.1016\/j.jhsg.2026.101112_bib24","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1302\/0301-620X.34B3.352","article-title":"Deformity of the elbow joint as a sequel to Erb\u2019s obstetrical paralysis","volume":"34B","author":"Aitken","year":"1952","journal-title":"J Bone Joint Surg"},{"issue":"134","key":"10.1016\/j.jhsg.2026.101112_bib25","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/bjs.18003413408","article-title":"Reconstruction of biceps brachii by pectoral muscle transplantation","volume":"34","author":"Clark","year":"1946","journal-title":"Br J Surg"},{"key":"10.1016\/j.jhsg.2026.101112_bib26","first-page":"357","article-title":"Restoration of muscle balance in the treatment of obstetrical paralysis","volume":"39","author":"L'Episcopo","year":"1939","journal-title":"NY J Med"},{"key":"10.1016\/j.jhsg.2026.101112_bib27","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1001\/jama.1925.02670240014005","article-title":"Obstetric paralysis: report of eleven hundred cases","volume":"85","author":"Sever","year":"1925","journal-title":"J Am Med Assoc"},{"key":"10.1016\/j.jhsg.2026.101112_bib28","series-title":"Orthopedic Operations","first-page":"129","author":"Steindler","year":"1940"},{"key":"10.1016\/j.jhsg.2026.101112_bib29","first-page":"115","article-title":"Obstetrical paralysis of the brachial plexus II. Therapeutics. Treatment of sequelae. Priority for the treatment of the shoulder","volume":"58","author":"Mallet","year":"1972","journal-title":"Rev Chir Orthop R\u00e9paratrice Appar Mot"},{"issue":"Suppl 97","key":"10.1016\/j.jhsg.2026.101112_bib30","first-page":"5","article-title":"Surgery of the paralysed and flail shoulder","author":"Saha","year":"1967","journal-title":"Acta Orthop Scand"},{"key":"10.1016\/j.jhsg.2026.101112_bib31","first-page":"187","article-title":"Birth injuries of the brachial plexus. Treatment of defects in the shoulder","volume":"23","author":"Wickstrom","year":"1962","journal-title":"Clin Orthop"},{"issue":"7","key":"10.1016\/j.jhsg.2026.101112_bib32","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.2106\/00004623-196749070-00003","article-title":"Paralytic supination contracture of the forearm","volume":"49","author":"Zancolli","year":"1967","journal-title":"J Bone Joint Surg Am"},{"issue":"A","key":"10.1016\/j.jhsg.2026.101112_bib33","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.2106\/00004623-197355060-00014","article-title":"Latissimus dorsi transfer to restore elbow flexion","volume":"55","author":"Zancolli","year":"1973","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jhsg.2026.101112_bib34","series-title":"Le paralisi ostetriche","first-page":"57","article-title":"Il loro trattamento precoce","author":"Morelli","year":"1984"},{"issue":"2","key":"10.1016\/j.jhsg.2026.101112_bib35","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S0030-5898(20)31393-6","article-title":"Brachial plexus surgery","volume":"12","author":"Narakas","year":"1981","journal-title":"Orthop Clin North Am"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib36","first-page":"70","article-title":"R\u00e9paration chirurgicale du plexus brachial dans la paralysie obst\u00e9tricale","volume":"110","author":"Gilbert","year":"1984","journal-title":"Chirurgie"},{"issue":"3","key":"10.1016\/j.jhsg.2026.101112_bib37","first-page":"159","article-title":"Les l\u00e9sions obst\u00e9tricales du plexus brachial","volume":"20","author":"Metaizeau","year":"1979","journal-title":"Chir Pediatr"},{"issue":"2","key":"10.1016\/j.jhsg.2026.101112_bib38","first-page":"93","article-title":"Cervical myelography with metrizamide in brachial birth palsies","volume":"23","author":"Neuenschwander","year":"1980","journal-title":"Ann Radiol (Paris)"},{"issue":"4","key":"10.1016\/j.jhsg.2026.101112_bib39","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/brain\/74.4.491","article-title":"A classification of peripheral nerve injuries producing loss of function","volume":"74","author":"Sunderland","year":"1951","journal-title":"Brain"},{"key":"10.1016\/j.jhsg.2026.101112_bib40","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/brain\/66.4.237","article-title":"Three types of nerve injury","volume":"66","author":"Seddon","year":"1943","journal-title":"Brain"},{"issue":"5","key":"10.1016\/j.jhsg.2026.101112_bib41","first-page":"591","article-title":"Contribution \u00e0 l'\u00e9tude des paralysies radiculaires du plexus brachial","author":"Klumpke","year":"1885","journal-title":"Revue de Medecine"},{"issue":"Neurol Sect","key":"10.1016\/j.jhsg.2026.101112_bib42","first-page":"31","article-title":"The complete histo-pathological examination of the nervous system of an unusual case of obstetrical paralysis forty-one years after birth, and a review of the pathology","volume":"5","author":"Boyer","year":"1912","journal-title":"Proc R Soc Med"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib43","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0094-1298(20)31834-4","article-title":"Thoughts on neurotization or nerve transfers in irreparable nerve lesions","volume":"11","author":"Narakas","year":"1984","journal-title":"Clin Plast Surg"},{"key":"10.1016\/j.jhsg.2026.101112_bib44","series-title":"Le paralisi ostetriche","first-page":"55","article-title":"Trattamento microchirurgico indicazione","author":"Narakas","year":"1984"},{"key":"10.1016\/j.jhsg.2026.101112_bib45","article-title":"Paralysies obst\u00e9tricales du plexus brachia, \u00e9volution spontan\u00e9e, r\u00e9sultats des interventions r\u00e9paratrices pr\u00e9coses","author":"Tassin","year":"1983","journal-title":"Carlioz H (dir) Th\u00e8se Universit\u00e9 Paris VII"},{"key":"10.1016\/j.jhsg.2026.101112_bib46","series-title":"Peripheral Nerve Injuries","first-page":"2","article-title":"Methods of investigation of nerve injuries","year":"1954"},{"key":"10.1016\/j.jhsg.2026.101112_bib47","series-title":"Muscles, Testing and Function","author":"Kendall","year":"1971"},{"issue":"1086","key":"10.1016\/j.jhsg.2026.101112_bib48","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1098\/rspb.1974.0064","article-title":"Contractile properties of muscle: control by pattern of muscle activity in the rat","volume":"187","author":"Lomo","year":"1974","journal-title":"Proc R Soc Lond B Biol Sci"},{"key":"10.1016\/j.jhsg.2026.101112_bib49","series-title":"Le paralisi ostetriche","first-page":"241","article-title":"Principi di neurofisiologia motoria et tecnica di facilitazione neuromuscolare secondo VOJTA","author":"Pizzetti","year":"1984"},{"issue":"3","key":"10.1016\/j.jhsg.2026.101112_bib50","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1302\/0301-620X.75B3.8496196","article-title":"Surgery for brachial plexus injuries","volume":"75","author":"Birch","year":"1993","journal-title":"J Bone Joint Surg Br"},{"issue":"6","key":"10.1016\/j.jhsg.2026.101112_bib51","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1177\/1753193409348185","article-title":"Narakas classification of obstetric brachial plexus palsy revisited","volume":"34","author":"Al-Qattan","year":"2009","journal-title":"J Hand Surg Eur Vol"},{"issue":"12","key":"10.1016\/j.jhsg.2026.101112_bib52","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1177\/00099228231163698","article-title":"Brachial plexus birth injury: a single-center study","volume":"62","author":"Caron","year":"2023","journal-title":"Clin Pediatr (Phila)"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib53","first-page":"47","article-title":"Brachial plexus birth injuries and the association between pre-procedure and post-procedure pediatric outcomes data collection instrument scores and narakas classification","volume":"13","author":"Eckstein","year":"2020","journal-title":"J Pediatr Rehabil Med"},{"key":"10.1016\/j.jhsg.2026.101112_bib54","doi-asserted-by":"crossref","first-page":"F185","DOI":"10.1136\/fn.88.3.F185","article-title":"Congenital brachial palsy: incidence, causes, and outcome in the United Kingdom and Republic of Ireland","volume":"88","author":"Evans-Jones","year":"2003","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib55","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ejogrb.2011.03.001","article-title":"Burnout, depression and anxiety levels in mothers of infants with brachial plexus injury and the effects of recovery on mothers' mental health","volume":"157","author":"Karadavut","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib56","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/PEP.0000000000001161","article-title":"Early conservative physical therapy management of babies with obstetric brachial plexus injury to facilitate spontaneous recovery","volume":"37","author":"Mahrouck","year":"2025","journal-title":"Pediatr Phys Ther"},{"issue":"6","key":"10.1016\/j.jhsg.2026.101112_bib57","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.jse.2007.02.124","article-title":"Forearm rotational profile in obstetric brachial plexus injury","volume":"16","author":"Sibinski","year":"2007","journal-title":"J Shoulder Elbow Surg"},{"issue":"1","key":"10.1016\/j.jhsg.2026.101112_bib58","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1590\/1413-78522015230101023","article-title":"Role of early shoulder tomography on the obstetric brachial plexus palsy","volume":"23","author":"Silva","year":"2015","journal-title":"Acta Ortop Bras"},{"key":"10.1016\/j.jhsg.2026.101112_bib59","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.pediatrneurol.2022.06.008","article-title":"Early spontaneous movements and upper extremity movement score in infants with all Narakas types of obstetric brachial plexus palsy","volume":"134","author":"Yard\u0131mc\u0131-Lokmano\u011flu","year":"2022","journal-title":"Pediatr Neurol"},{"issue":"6","key":"10.1016\/j.jhsg.2026.101112_bib60","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s11832-009-0208-3","article-title":"Prognosis following neonatal brachial plexus palsy: an evidence-based review","volume":"3","author":"Foad","year":"2009","journal-title":"J Child Orthop"},{"key":"10.1016\/j.jhsg.2026.101112_bib61","doi-asserted-by":"crossref","DOI":"10.1177\/17531934251408606","article-title":"Brachial plexus birth injury: classification, natural history and shoulder external rotation","author":"Hems","year":"2026","journal-title":"J Hand Surg Eur Vol"},{"key":"10.1016\/j.jhsg.2026.101112_bib62","article-title":"A novel intraoperative classification for brachial plexus birth injury based on operative findings in 162 patients","author":"Zlotolow","year":"2025","journal-title":"J Hand Surg Eur Vol"}],"container-title":["Journal of Hand Surgery Global Online"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589514126001672?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589514126001672?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:38:45Z","timestamp":1788601125000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589514126001672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2027,1]]},"references-count":62,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,1]]}},"alternative-id":["S2589514126001672"],"URL":"https:\/\/doi.org\/10.1016\/j.jhsg.2026.101112","relation":{},"ISSN":["2589-5141"],"issn-type":[{"value":"2589-5141","type":"print"}],"subject":[],"published":{"date-parts":[[2027,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Revisiting the Original Narakas Classification of Brachial Plexus Birth Injuries","name":"articletitle","label":"Article Title"},{"value":"Journal of Hand Surgery Global Online","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jhsg.2026.101112","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 THE AUTHORS. Published by Elsevier Inc. on behalf of The American Society for Surgery of the Hand.","name":"copyright","label":"Copyright"}],"article-number":"101112"}}