Primary nerve surgery for obstetric brachial plexus palsy: an updated systematic review (2014-2026) of effectiveness, nerve graft versus nerve transfer, and timing of surgery

This registration covers an update of a systematic review of primary nerve surgery for obstetric brachial plexus palsy (OBPP) in infants and children operated before 24 months of age. It addresses (1) surgery versus conservative management, (2) nerve grafting versus nerve transfer, and (3) early (before 6 months) versus late surgery, on shoulder and elbow motor recovery. It updates and corrects a review covering 2014-2019 (31 studies, narrative synthesis; [confirm that no protocol was registered]). The new review covers 1 January 2014 to 30 September 2026, with reproducible search equations, duplicate screening and extraction, validated risk-of-bias tools (RoB 2, ROBINS-I, JBI) and GRADE.