Correlation of Pediatric Outcomes Data Collection Instrument With Measures of Active Movement in Children With Brachial Plexus Birth Palsy

Aims To describe and analyze the mid-term functional outcomes of a large series of patients who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP). Methods All patients who underwent the Hoffer procedure with minimum two-year follow-up were retrospectively reviewed. Active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores were used to assess functional outcomes. Subgroup analysis based on age and level of injury was performed. Risk factors for subsequent humeral derotational osteotomy and other complications were also assessed. A total of 107 patients, average age 3.9 years (1.6 to 13) and 59% female, were included in the study with mean 68 months (24 to 194) follow-up. Results All patients demonstrated statistically significant improvement in all functional outcomes and active shoulder abduction and external rotation ROM (p < 0.001). Patients < 2.5 years of age had higher postoperative AMS, abduction ROM and strength scores, and aggregate postoperative Toronto scores (p ≤ 0.035) compared to patients ≥ 2.5 years old. There were 17 patients (16%) who required a subsequent humeral derotational osteotomy; lower preoperative AMS external rotation scores and external rotation ROM were predictive risk factors (p ≤ 0.016). Conclusion Patients with BPBP who underwent the Hoffer procedure demonstrated significant improvement in postoperative ROM, strength, and functional outcome scores at mid-term follow-up. Patients younger than 2.5 years at the time of surgery generally had better functional outcomes. Limited preoperative external rotation strength and ROM were significantly associated with requirement for subsequent humeral derotational osteotomy. In our chort significant improvements in shoulder function were obtained after the Hoffer procedure for BPBP. Cite this article: Bone Joint J 2020;102-B(2):246–253.

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Combined Glenoid Anteversion Osteotomy and Tendon Transfers for Brachial Plexus Birth Palsy [3 modifications and 3 technical tips to make our life easier]

10.26226/morressier.59bbcdd7d462b80292389967 ◽

2017 ◽

Author(s):

AAOS at DKOU 2017

Keyword(s):

Brachial Plexus ◽

Tendon Transfers ◽

Brachial Plexus Birth Palsy ◽

Birth Palsy

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Lack of effectiveness of primary conservative management for infants with brachial plexus birth palsy

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-200907100-00001 ◽

2009 ◽

Vol 7 (10) ◽

pp. 354-386

Author(s):

Andrea Emmi Bialocerkowski ◽

Sharon Vladusic ◽

Rosemary Patricia Moore

Keyword(s):

Brachial Plexus ◽

Conservative Management ◽

Brachial Plexus Birth Palsy ◽

Birth Palsy

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Effect of Tendon Transfers and Extra-Articular Soft-Tissue Balancing on Glenohumeral Development in Brachial Plexus Birth Palsy

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.c.01614 ◽

2005 ◽

Vol 87 (2) ◽

pp. 320-325 ◽

Cited By ~ 94

Author(s):

Peter M. Waters ◽

Donald S. Bae

Keyword(s):

Soft Tissue ◽

Brachial Plexus ◽

Tendon Transfers ◽

Soft Tissue Balancing ◽

Brachial Plexus Birth Palsy ◽

Birth Palsy

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Range of motion and strength after surgery for brachial plexus birth palsy

Acta Orthopaedica ◽

10.3109/17453674.2010.539499 ◽

2010 ◽

Vol 82 (1) ◽

pp. 69-75 ◽

Cited By ~ 7

Author(s):

Mikko O Kirjavainen ◽

Yrjänä Nietosvaara ◽

Sanna M Rautakorpi ◽

Ville M Remes ◽

Tiina H Pöyhiä ◽

...

Keyword(s):

Brachial Plexus ◽

Range Of Motion ◽

Brachial Plexus Birth Palsy ◽

Birth Palsy

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Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Journal of Brachial Plexus and Peripheral Nerve Injury ◽

10.1055/s-0041-1731748 ◽

2021 ◽

Vol 16 (01) ◽

pp. e51-e55

Author(s):

Jasmine J. Lin ◽

Gromit Y.Y. Chan ◽

Cláudio T. Silva ◽

Luis G. Nonato ◽

Preeti Raghavan ◽

...

Keyword(s):

Brachial Plexus ◽

Upper Extremity ◽

Muscle Activity ◽

Visual Analytics ◽

Three Dimensional ◽

Trapezius Muscle ◽

Shoulder Abduction ◽

Upper Trapezius ◽

Brachial Plexus Birth Palsy ◽

Birth Palsy

Abstract Background The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method An 18-year-old female with extended upper trunk (C5–6–7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.

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