Arthroscopic treatment of posterior glenohumeral joint subluxation resulting from brachial plexus birth palsy

The Evaluation and Treatment of Children With Brachial Plexus Birth Palsy

“…We embarked on a prospective clinical research study to assess the efficacy of arthroscopic capsular release to reduce the glenohumeral joint in the short term and to maintain the reduction in the long term. 8,9 In addition, we sought to assess the effects of this procedure on joint remodeling. We initially enrolled 22 children with an average age of 3.9 years (range, 1.6 -8.3 y).…”

“…We initially enrolled 22 children with an average age of 3.9 years (range, 1.6 -8.3 y). 8 All children underwent preoperative MRI, arthroscopic surgery with or without tendon transfers, and postoperative imaging in the spica cast. For the uninvolved shoulder, the mean percentage of the humeral head anterior to the middle of the glenoid fossa (PHHA) was 45% Ϯ 5% and the glenoid version was Ϫ7°Ϯ 3°.…”

“…Infants with uppertrunk birth palsies who demonstrate considerable recovery within the first 2 months usually recover normal function. 8 Infants with delayed recovery fail to regain full shoulder movement, because rotator cuff and deltoid innervation is incomplete. Incomplete recovery leads to muscle imbalance characterized by strong internal rotators and weak external rotators, commonly leading to an internal rotation contracture (Fig.…”

Arthroscopic treatment for internal contracture of the shoulder secondary to brachial plexus birth palsy: report of a case series and review of the literature

“…Since Pearl et al [8] described the arthroscopic technique for the treatment of internal rotation contracture in BPBP, various authors have reported their experiences with this technique, and some 200 cases have been described [17][18][19][20][21][22][23][24] (Table 3).…”

Shoulder sequelae in children with brachial plexus palsy

“…His pro tocol included arthroscopic release and reduction of the glenohumeral joint only in young children (younger than 3 years of age) and simultaneous tendon transfer in older children. Similarly, Pedow itz et al 31 reported significant improvement in pos terior humeral head angle (PHHA) and glenoid version following arthroscopic release of internal rotation contractures with or without tendon trans fers. Kozin and colleagues 32 followed 44 patients who underwent arthroscopic release, with or without tendon transfers to realign a dysplastic glenohumeral joint in children with brachial plexus palsy.…”