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    • The incidence of brachial plexus birth injury (BPBI) in the United States is declining and now occurs in <1 per 1,000 births.
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    • The gold standard for predicting the need for early intervention remains serial examination.
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    • Early treatment of BPBI with reconstructive surgery requires the ability to perform both interposition nerve grafting and nerve transfers.
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    • Given the heterogeneity of lesions, the evidence is largely limited to retrospective comparative studies and case series.