Treatment approach to shoulder internal rotation deformity in children with obstetric brachial plexus palsy
- 作者: Agranovich O.E.1, Oreshkov A.B.1, Mikiashvili E.F.1
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隶属关系:
- The Turner Scientific Research Institute for Children’s Orthopedics
- 期: 卷 6, 编号 2 (2018)
- 页面: 22-28
- 栏目: Original papers
- URL: https://bakhtiniada.ru/turner/article/view/8985
- DOI: https://doi.org/10.17816/PTORS6222-28
- ID: 8985
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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.
作者简介
Olga Agranovich
The Turner Scientific Research Institute for Children’s Orthopedics
编辑信件的主要联系方式.
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
MD, PhD, Professor, Head of the Department of Arthrogryposis.
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Anatoly Oreshkov
The Turner Scientific Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-2946-1850
MD, PhD, Orthopedic and Trauma Surgeon of the Department of Arthrogryposis.
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Evgeniya Mikiashvili
The Turner Scientific Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
MD, Orthopedic and Trauma Surgeon of the Department of Arthrogryposis.
俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603参考
- Laurent JP, Lee R, Shenaq S, et al. Neurosurgical correction of upper brachial plexus birth injuries. J Neurosurg. 1993;79(2):197-203. doi: 10.3171/jns.1993.79.2.0197.
- Waters PM. Obstetric Brachial Plexus Injuries: Evaluation and Management. J Am Acad Orthop Surg. 1997;5(4):205-214.
- Hoeksma AF, ter Steeg AM, Nelissen RG, et al. Neurological recovery in obstetric brachial plexus injuries: an historical cohort study. Dev Mecd Child Neurol. 2004;46(2):76-83. doi: 10.1017/S0012162204000179.
- Foad SL, Mehlman CT, Ying J. The epidemiology of neonatal brachial plexus palsy in the United States. J Bone Joint Surg Am. 2008;90(6):1258-1264. doi: 10.2106/JBJS.G.00853.
- Chagas-Neto FA, Dalto VF, Crema MD, et al. Imaging assessment of glenohumeral dysplasia secondary to brachial plexus birth palsy. Radiol Bras. 2016;49(3):144-149. doi: 10.1590/0100-3984.2015.0039.
- Hale HB, Bae DS, Waters PM. Current concepts in the management of brachial plexus birth palsy. J Hand Surg. 2010;35(2):322-331. doi: 10.1016/j.jhsa.2009.11.026.
- Buterbaugh KL, Shah AS. The natural history and management of brachial plexus birth palsy. Curr Rev Musculoskelet Med. 2016;9(4):418-426. doi: 10.1007/s12178-016-9374-3.
- Hoeksma AF, Wolf H, Oei SL. Obstetrical brachial plexus injuries: incidence, natural course and shoulder contracture. Clin Rehabil. 2000;14(5):523-526. doi: 10.1191/0269215500cr341oa.
- Birch R. Obstetric brachial plexus palsy. In: The growing hand. Ed by A. Gupta, S.P.J. Kay, L.R. Scheker. Philadelphia: Mosby; 2000. P. 461-474.
- Birch R. Medial rotation contracture, posterior dislocation of the shoulder. In: Brachial plexus injuries. Ed by A. Gilbert. Hampshire (UK): Taylor & Francis; 2001. P. 249-259.
- Nath RK, Melcher SE, Paizi M. Surgical correction of unsuccessful derotational humeral osteotomy in obstetric brachial plexus palsy: evidence of the significance of scapular deformity in the pathophysiology of the medial rotation contracture. J Brachial Plex Peripher Nerve Inj. 2006;1:9. doi: 10.1186/1749-7221-1-9.
- Waters PM, Bae DS. Effect of tendon transfers and extra-articular soft-tissue balancing on glenohumeral development in brachial plexus birth palsy. J Bone Joint Surg Am. 2005;87(2):320-325. doi: 10.2106/JBJS.C.01614.
- Muhlig RS, Blaauw G, Slooff ACJ, et al. Conservative treatment of obstetrical brachial plexus palsy (OBPP) and rehabilitation. In: Brachial Plexus Injuries. Ed by A. Gilbert. London: Martin Dunitz Ltd; 2001. P. 173-183.
- Al-Qattan MM. Classification of secondary shoulder deformities in obstetric brachial plexus palsy. J Hand Surg Eur Vol. 2003;28(5):483-486. doi: 10.1016/S0266-7681(02)00399-6.
- Nath RK, Liu X, Melcher SE, Fan J. Long-term outcomes of triangle tilt surgery for obstetric brachial plexus injury. Pediatr Surg Int. 2010;26(4):393-399. doi: 10.1007/s00383-010-2550-4.
- Dodwell E, O’Callaghan J, Anthony A, et al. Combined glenoid anteversion osteotomy and tendon transfers for brachial plexus birth palsy: early outcomes. J Bone Joint Surg Am. 2012;94(23):2145-2152. doi: 10.2106/JBJS.K.01256.
- Nath RK, Somasundaram C. Improvements after mod Quad and triangle tilt revision surgical procedures in obstetric brachial plexus palsy. World J Orthop. 2016;7(11):752-757. doi: 10.5312/wjo.v7.i11.752.
- Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am. 1992;74(7):1032-1037.
- Waters PM, Smith GR, Jaramillo D. Glenohumeral deformity secondary to brachial plexus birth palsy. J Bone Joint Surg Am. 1998;80(5):668-677.
- Ruchelsman DE, Grossman JA, Price AE. Glenohumeral deformity in children with brachial plexus birth injuries. Bull NYU Hosp Jt Dis. 2011;69(1):36-43.
- van der Sluijs JA, van Ouwerkerk WJ, de Gast A, et al. Deformities of the shoulder in infants younger than 12 months with an obstetric lesion of the brachial plexus. J Bone Joint Surg Br. 2001;83(4):551-555. doi: 10.1302/0301-620X.83B4.11205.
- Soldado F, Benito-Castillo D, Fontecha CG, et al. Muscular and glenohumeral changes in the shoulder after brachial plexus birth palsy: an MRI study in a rat model. J Brachial Plex Peripher Nerve Inj. 2012;7(1):9. doi: 10.1186/1749-7221-7-9.
- Kozin SH. Correlation between external rotation of the glenohumeral joint and deformity after brachial plexus birth palsy. J Pediatr Orthop. 2004;24(2):189-193. doi: 10.1097/00004694-200403000-00011.
- Zancolli EA, Zancolli ER. Reconstructive surgery in brachial plexus sequelae. In: The growing hand. Ed by A. Gupta, S.P.J. Kay, L.R. Scheker. London: UK: Mosby; 2000. P. 805-823.
- Pearl ML, Edgerton BW. Glenoid deformity secondary to brachial plexus birth palsy. J Bone Joint Surg Am. 1998;80(5):659-667.
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