Obstetric Brachial Plexus Palsy in Newborn Babies of Diabetic and Non-Diabetic Mothers

2010 ◽  
Vol 35 (5) ◽  
pp. 362-365 ◽  
Author(s):  
M.M. Al-Qattan ◽  
A.A.F. El-Sayed ◽  
A.Y. Al-Zahrani ◽  
S.A. Al-Mutairi ◽  
M.S. Al-Harbi ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Spontaneous Recovery ◽  
External Rotation ◽  
Elbow Flexion ◽  
Motor Power ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation ◽  
Diabetic Mothers

Compared to non-diabetic mothers, diabetic mothers are known to deliver larger babies who are at higher risk for shoulder dystocia and obstetric brachial plexus palsy. The intrapartum forces applied during delivery of larger babies are expected to be higher. Hence, the chances of these babies for good spontaneous recovery are expected to be lower; and this is a generally believed hypothesis. The objective of this retrospective study was to compare obstetric brachial plexus palsy in newborn babies of diabetic and non-diabetic mothers. There were a total of 655 cases of obstetric palsy: 253 cases with diabetic mothers and 402 with non-diabetic mothers. The former were more likely to develop total palsy while the latter were more likely to develop extended Erb’s palsy. Newborn babies of diabetic mothers had significantly larger birth weights than those of non-diabetic mothers regardless of the type of palsy. The rate of good spontaneous recovery of the motor power of the limb in the two groups was not significantly different except in total palsy cases for shoulder external rotation and elbow flexion where the recovery was significantly better in the diabetic group. It was concluded that the generally believed hypothesis is not correct if one compares the outcome in the diabetic and non-diabetic groups for each type of palsy.

Latissimus Dorsi Transfer for External Rotation Weakness of the Shoulder in Obstetric Brachial Plexus Palsy

2003 ◽  
Vol 28 (5) ◽  
pp. 405-408 ◽  
Author(s):  
M. M. Al-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Skeletal Development ◽  
Shoulder Abduction ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Latissimus Dorsi Transfer ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation

This report describes the results of latissimus dorsi transfer for weakness of shoulder external rotation in 12 children with obstetric brachial plexus palsy. Selection criteria for the muscle transfer procedure included good passive external rotation of the shoulder, normal skeletal development of the shoulder joint, and adequate power of the deltoid. In addition to measuring the ranges of motion of joints before and after surgery, a modified Mallet grading system was utilized for the functional assessment of shoulder external rotation. At a mean follow-up of 4 years, two of the 12 children had recurrence of the shoulder deformity. In the remaining 10 children, the mean active external rotation was 30° (range, 20–60°), mean shoulder abduction was 140° (range, 90–170°), and all children had achieved a modified Mallet score of 4.

scholarly journals Obstetric Brachial Plexus Palsy: The Mallet Grading System for Shoulder Function—Revisited

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
M. M. Al-Qattan ◽  
A. A. F. El-Sayed
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Shoulder Function ◽  
Shoulder Abduction ◽  
Grading System ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation

The Mallet grading system is a commonly used functional scoring system to assess shoulder abduction/external rotation deficits in children with obstetric brachial plexus palsy. One feature of the Mallet score is that each grade is translated into certain degrees of deficiencies in both shoulder abduction and external rotation. The aim of the current study is to investigate the percentage of children in which the Mallet score could not be applied because of a discrepancy between the deficiency of shoulder abduction and shoulder external rotation. The study group included 50 consecutive unoperated older children (over 5 years of age) with Erb’s palsy and deficits in shoulder movements. The Mallet score could be applied in 40 cases (80%). In the remaining 10 cases (20%), the Mallet score could not be applied either because shoulder abduction had a better grade than the grade of shoulder external rotation (n=7) or vice versa (n=3). It was concluded that documenting the deficits in shoulder abduction and external rotation are best done separately and this can be accomplished by using other grading systems.

Obstetric Brachial Plexus Palsy: a Comparison of Affected Infants Delivered Vaginally By Breech or Cephalic Presentation

2010 ◽  
Vol 35 (5) ◽  
pp. 366-369 ◽  
Author(s):  
M.M. Al-Qattan ◽  
A.A.F. El-Sayed ◽  
A.Y. Al-Zahrani ◽  
S.A. Al-Mutairi ◽  
M.S. Al-Harbi ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Spontaneous Recovery ◽  
Elbow Flexion ◽  
Shoulder Abduction ◽  
Brachial Plexus Palsy ◽  
Phrenic Nerve Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Breech Delivery ◽  
Erb’S Palsy ◽  
Obstetric Brachial Plexus

In this retrospective study we compared obstetric brachial plexus palsy (OBPP) in two non-operated groups of newborn babies delivered vaginally by breech or cephalic presentation. There were 35 cases of OBPP in the breech group and 663 cases in the cephalic group. The former group was more likely to develop upper Erb’s palsy while the latter group was more likely to develop total palsy. The breech group also had a significantly lower mean birth weight, a significantly higher percentage of bilateral OBPP palsies and concurrent phrenic nerve palsy. Spontaneous recovery of shoulder abduction and elbow flexion in newborn babies with upper Erb’s palsy was significantly worse in the breech compared with the cephalic group. It was concluded that OBPP following vaginal breech delivery has several unique demographic features and breech babies with upper Erb’s palsy have a worse prognosis for spontaneous recovery than those in the cephalic group.

Bilateral Elbow Flexion Reconstruction with Functioning Free Muscle Transfer for Obstetric Brachial Plexus Palsy

2002 ◽  
Vol 27 (5) ◽  
pp. 484-486 ◽  
Author(s):  
A. S. BALIARSING ◽  
K. DOI ◽  
Y. HATTORI
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Gracilis Muscle ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Nerve Roots ◽  
Obstetric Brachial Plexus Palsy ◽  
Shoulder Joints ◽  
Muscle Transfers ◽  
Obstetric Brachial Plexus

A child suffered a bilateral obstetric brachial plexus palsy involving the C5 and C6 nerve roots. Abduction of the shoulder joints had recovered by 1 year, but elbow flexion did not recover on either side. Free gracilis muscle transfers were performed on both sides, at an interval of 6 months, to achieve elbow flexion. The spinal accessory nerve was used as the donor nerve.

Assessment of the Motor Power in Older Children with Obstetric Brachial Plexus Palsy

2003 ◽  
Vol 28 (1) ◽  
pp. 46-49 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Grading System ◽  
Motor Power ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
King Saud University ◽  
Grading Systems ◽  
Obstetric Brachial Plexus

The King Saud University (KSU) muscle grading system used for assessing the upper limb in older children with obstetric brachial plexus palsy is presented and compared to other muscle grading systems.

Elbow Flexion Reconstruction by Steindler Flexorplasty in Obstetric Brachial Plexus Palsy

2005 ◽  
Vol 30 (4) ◽  
pp. 424-427 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Selection Criteria ◽  
Elbow Flexion ◽  
Drill Hole ◽  
Flexion Contracture ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

The results of Steindler flexorplasty in nine patients with obstetric brachial plexus palsy are reported. There were 5 girls and 4 boys with a mean age of 6 (range 2–13) years. Selection criteria for the procedure included strong (at least M4) grip strength and wrist and elbow extension, as well as the presence of the “Steindler effect”. Pre-operatively, elbow flexion was rated as M0 or M1 in three patients and M2 in the remaining six patients. Intra-operatively, the detached common flexor origin was advanced 5 to 7 cm and fixation was done to the anterior humerus either with direct suture to the periosteum (in younger children) or suturing into a drill hole in the humerus (in older children). Postoperatively, the elbow was immobilized in flexion and supination for 6 weeks. At a mean follow-up of 5 years, the results in eight patients were good with mean active elbow flexion against resistance of 110° and a mean elbow flexion contracture of 35°. The result in the remaining patient was poor (unsuccessful transfer). It is concluded that the results of the Steindler flexorplasty in obstetric brachial plexus palsy patients are good and reliable, provided patient selection is careful.

Sign in / Sign up

Export Citation Format

Share Document