scholarly journals Reconstruction of shoulder abduction and external rotation with latissimus dorsi and teres major transfer in obstetric brachial plexus palsy

2010 ◽  
pp. 186-193 ◽  
Author(s):  
Kahraman Ozturk
Keyword(s):  
Brachial Plexus ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Shoulder Abduction ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Teres Major

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.

An adjustable shoulder abduction orthosis for the post-operative management of tendon transfers: A preliminary study

2008 ◽  
Vol 32 (2) ◽  
pp. 129-135 ◽  
Author(s):  
Suat Erel ◽  
İbrahim Engin Şimşek ◽  
Çiğdem Ayhan ◽  
Nilgün Bek ◽  
Yavuz Yakut ◽  
...  
Keyword(s):  
External Rotation ◽  
Operative Management ◽  
Shoulder Abduction ◽  
Rehabilitation Center ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Musculus Latissimus Dorsi ◽  
Obstetric Brachial Plexus ◽  
Teres Major ◽  
Preliminary Study

Transfer of Musculus Latissimus dorsi/M. Teres major to the rotator cuff with or without M. Subscapularis/M. Pectoralis release is a widely used procedure for restoring shoulder abduction and external rotation in squeal of obstetric brachial plexus palsy. After the operation a shoulder abduction orthosis in maximal external rotation and 90 – 100° abduction is utilized following six weeks of immobilization in a shoulder spica cast for protecting the newly transferred muscle from undue elongation. However this in turn may cause contracture of the external rotators. To overcome this problem, a modified shoulder abduction splint with adjustable internal-external rotation/abduction-adduction ranges was developed in the orthotics department of a rehabilitation center. The custom molded adjustable shoulder abduction orthosis is described and the preliminary results are compared with former applications.

Classification of Impairment of Shoulder Abduction in Obstetric Brachial Plexus Palsy and its Clinical Significance

2000 ◽  
Vol 25 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Y-D. GU ◽  
L. CHEN ◽  
L-Y. SHEN
Keyword(s):  
Brachial Plexus ◽  
Shoulder Abduction ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
X Ray ◽  
Subscapularis Muscle ◽  
Dynamic Type ◽  
Obstetric Brachial Plexus ◽  
Teres Major

Shoulder abduction was studied in 25 cases of obstetric brachial plexus palsy (OBPP). According to muscle function, electromyographic features and X-ray examination, impairment of shoulder abduction could be classified into dynamic, resistant or combined types. Five cases were the dynamic type, which was characterized by paralysis of the shoulder abductors. Fifteen cases were categorized as the resistant type, with contracture of the subscapularis muscle, co-contraction of latissimus dorsi and teres major muscles and secondary disorders of the shoulder joint. Five cases were classified as the combined type in which there were both dynamic and resistant factors. Appropriate management and surgical procedures in the shoulder affected by OBPP depend on the pathological classification.

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.

scholarly journals Results of Sever- L’ Episcopo procedure for obstetric brachial plexus palsy

2016 ◽  
Vol 3 (1) ◽  
pp. 50
Author(s):  
Karthi Sundar V. ◽  
Anil Kumar S.V.
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Social Stigma ◽  
Functional Results ◽  
Functional Improvement ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Teres Major

<p class="abstract"><strong>Background:</strong> The reported incidence of obstetric brachial plexus palsy (OBPP) varies from 0.3 to 2.5 per 1000 live births<strong></strong>resulting in internal rotation deformity and weak abduction of the involved side shoulder<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> To retrospectively analyse the functional results of the Sever- L‘ Episcopo procedure for OBPP with a minimum follow-up of 2 years to a maximum of 13 years using modified Mallet scoring system for shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> A significant improvement in the range of abduction and the restoration of external rotation of shoulder was achieved with Sever- L’Episcopo procedure<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The results of secondary reconstruction of a dysfunctional shoulder by means of a Lattismus dorsi &amp; Teres major transfer as described by Sever- L’Episcopo is definitely beneficial. However this procedure will improve, but will not normalize, function. Apart from functional improvement this procedure corrects a deformity thereby easing the psycho-social stigma associated with it<span lang="EN-IN">.</span></p>

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.

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.

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