scholarly journals Treatment approach to shoulder internal rotation deformity in children with obstetric brachial plexus palsy

2018 ◽  
Vol 6 (2) ◽  
pp. 22-28 ◽  
Author(s):  
Olga E. Agranovich ◽  
Anatoly B. Oreshkov ◽  
Evgeniya F. Mikiashvili
Keyword(s):  
Brachial Plexus ◽  
Internal Rotation ◽  
Upper Limb ◽  
Glenohumeral Joint ◽  
Brachial Plexus Palsy ◽  
Limb Function ◽  
Obstetric Brachial Plexus Palsy ◽  
Tendon Transfers ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus

Introduction. Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with obstetric brachial plexus palsy because of the subsequent imbalance of the musculature and the abnormal deforming forces that cause dysplasia of the glenohumeral joint. Aim. To assess the effects of tendon transfers in children with shoulder internal rotation deformity due to obstetric brachial plexus palsy. Materials and methods. From 2015 to 2017, we examined and treated 15 patients with shoulder internal rotation deformity caused by obstetric brachial plexus palsy. The children ranged in age from 4 to 17 years. We used clinical and radiographic examination methods, including magnetic resonance imaging, electromyography, and electroneuromyography, of the upper limbs. Results. According to the level of plexus brachialis injury, the patients were divided into 3 groups: level С5–С6 (9 patients), level C5–C7 (5 children), level С5–Th1 (1 patient). All children had secondary shoulder deformities: glenohumeral dysplasia type II, 6 (40%); type III, 5 (34%); type IV, 1 (6%); and type V, 3 (20%). The Mallet score was used for estimation of upper limb function. Surgical treatment was performed in 15 children. After treatment, all patients showed improvement in activities of daily living. Conclusion. Tendon transfers in patients with shoulder internal rotation deformities due to obstetric brachial plexus palsy improved upper limb function and provided satisfactory cosmetic treatment results without of remodeling of the glenohumeral joint.

scholarly journals Humeral Rotational Osteotomy for Shoulder Deformity in Obstetric Brachial Plexus Palsy: Which Direction Should I Rotate?

2014 ◽  
Vol 8 (1) ◽  
pp. 130-134 ◽  
Author(s):  
Amr A Abdelgawad ◽  
Miguel A Pirela-Cruz
Keyword(s):  
Brachial Plexus ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Orthopedic Surgeons ◽  
Obstetric Brachial Plexus ◽  
Shoulder Deformity ◽  
Rotation Osteotomy

Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with Obstetric Brachial Plexus Palsy. With progression of the deformity, the glenohumeral joint starts to subluxate and then dislocates. This is accompanied with bony changes of both the humerus and the glenoid. Two opposite direction humeral osteotomies have been proposed for this condition (internal rotation osteotomy (IRO) and external rotation osteotomy (ERO)). This fact of different direction osteotomies has not adequately been explained in the literature. Most orthopedic surgeons may not be able to fully differentiate between these two osteotomies regarding the indications, outcomes and effects on the joint. This review explains these differences in details.

Obstetric Brachial Plexus Lesions: A Study of 74 Children Registered with the British Paediatric Surveillance Unit (March 1998–March 1999)

2003 ◽  
Vol 28 (1) ◽  
pp. 40-45 ◽  
Author(s):  
G. L. BISINELLA ◽  
R. BIRCH
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Surgical Correction ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Good Function ◽  
Secondary Deformity ◽  
Obstetric Brachial Plexus ◽  
Shoulder Deformity ◽  
Surveillance Unit

Seventy-four children with obstetric brachial plexus palsy registered with the British Paediatric Surveillance Unit were prospectively followed for a minimum of 2 years. Thirty-nine (52.7%) spontaneously recovered to normal or nearly normal levels and a further 29 (39.3%) regained good function in the upper limb. The most important secondary deformity involved the gleno-humeral joint and 20 patients (27%) needed surgical correction. Two more children await operation for shoulder deformity. The brachial plexus was explored in nine patients (12.2%) and repaired in seven.

Functional Scoring System for Obstetric Brachial Plexus Palsy

2000 ◽  
Vol 25 (1) ◽  
pp. 41-45 ◽  
Author(s):  
H. BASHEER ◽  
V. ZELIC ◽  
F. RABIA
Keyword(s):  
Brachial Plexus ◽  
Scoring System ◽  
Good Recovery ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus ◽  
Good Score ◽  
New Scoring

We suggest a new scoring system that measures the upper limb function both as a unit and in separate parts. Our system was designed to study the recovery in patients with obstetric brachial plexus palsy (OBPP). It measures active limb movements and compares them with the normal side to obtain a ratio, which is then converted to a score. Fifty-two patients with OBPP were studied with a follow-up of 2 years. The progress of the patients was monitored using the system. Thirty-seven patients (71%) achieved very good recovery, eight patients (15%) achieved a good score, and five patients (10%) achieved a poor score. Most of the recovery occurred before the age of 6 months.

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.

Secondary procedures for restoration of upper limb function in late cases of neonatal brachial plexus palsy

2019 ◽  
Vol 29 (2) ◽  
pp. 329-336 ◽  
Author(s):  
Marios D. Vekris ◽  
Dimitrios V. Papadopoulos ◽  
Ioannis D. Gelalis ◽  
Vasilios Kontogeorgakos ◽  
Andreas G. Tsantes ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Palsy ◽  
Limb Function ◽  
Upper Limb Function ◽  
Neonatal Brachial Plexus Palsy ◽  
Secondary Procedures

Long-Term Results of Low Rotation Humeral Osteotomy in Children with Erb’s Obstetric Brachial Plexus Palsy

2009 ◽  
Vol 34 (4) ◽  
pp. 486-492 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
H. AL-HUSAINAN ◽  
A. AL-OTAIBI ◽  
M. S. EL-SHARKAWY
Keyword(s):  
Brachial Plexus ◽  
Internal Rotation ◽  
Long Term Results ◽  
Shoulder Abduction ◽  
Brachial Plexus Palsy ◽  
Extension Deficit ◽  
Obstetric Brachial Plexus Palsy ◽  
Long Term Follow Up ◽  
Obstetric Brachial Plexus

Seventeen children with Erb’s (C5/6 and C5/6/7 types) obstetric brachial plexus palsy who underwent low rotation humeral osteotomy to treat internal rotation contracture of the shoulder were recalled back to the clinic at a mean of 10 (range 8–14) years after surgery. Eight were male and nine female with mean age of 16 (range 13–20) years. The osteotomy procedure was done at a mean age of 6 (range 5–8) years. Preoperative, early postoperative, and late postoperative motor assessments were compared. There was no recurrence of the internal rotation posturing of the shoulder and there was maintenance of the improvements in elbow extension deficit and forearm rotation. The most surprising finding was a significant ( P = 0.003) decrease in shoulder abduction on long-term follow-up (the mean shoulder abduction was 135 °, 146° and 109° measured pre-, early post- and late postoperatively, respectively). There was no correlation between changes in shoulder abduction and the radiological score of the shoulder.

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