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1. A long-term follow-up in eighty-eight patients with obstetrical palsy (Erb's) is presented.2. Although the incidence has decreased over the years, this birth injury still occurs and presents problems in diagnosis and prognosis as well as early and late management.3. Maximum recovery may require eighteen months.4. Contractures can and do occur quickly. All infants in whom the diagnosis is suspected should be treated immediately. The most important aspect of early treatment is the prevention of contractures by passive exercises. Bracing is inherently dangerous since it may cause permanent contractures and should be avoided.5. Existing contractures or deformities must be corrected before reconstructive procedures are performed.6. At the time of follow-up virtually all the adult patients in this series were living useful, active lives.7. The most neglected, perplexing, and disabling problem still is that of the deformed elbow. Thirty-eight of the eighty-eight patients examined in the follow-up had some form of elbow involvement.