Biceps Brachii Long Head Overactivity Associated with Elbow Flexion Contracture in Brachial Plexus Birth Palsy

Sheffler, Lindsey C.; Lattanza, Lisa; Sison-Williamson, Mitell; James, Michelle A.

doi:10.2106/jbjs.j.01348

Cited by 29 publications

(24 citation statements)

References 34 publications

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“…10 On the other hand, Ballinger's and Hoffer's 6 suggestion that flexor weakness correlates with elbow flexion contracture severity is inconsistent with our results. A recent study 22 suggested single muscle overactivity as a factor: overactivity of the long head of the biceps was related to elbow flexion contractures based on EMG findings in older children (mean age 14 years). Our EMG findings are not precise enough to refute or support this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Elbow Flexion Contractures in Childhood in Obstetric Brachial Plexus Lesions: A Longitudinal Study of 20 Neurosurgically Reconstructed Infants with 8-Year Follow-up

Sluijs

Ouwerkerk

Sluijs

et al. 2015

J Brachial Plex Peripher Nerve Inj

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Section: Discussionmentioning

confidence: 99%

Elbow Flexion Contractures in Childhood in Obstetric Brachial Plexus Lesions: A Longitudinal Study of 20 Neurosurgically Reconstructed Infants with 8-Year Follow-up

Sluijs

Ouwerkerk

Sluijs

et al. 2015

J Brachial Plex Peripher Nerve Inj

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“…48 Contracture is thought to be due to overactivity of the long head of the biceps brachii muscle serving as an additional anterior stabilizer of an abnormal glenohumeral joint. 49 Currently, the mainstays of treatment for elbow flexion contracture in children with BPBP are serial casting and nighttime splinting. A recently published treatment algorithm recommends serial casting for contractures of Z40 degrees and nighttime splinting for contractures of 20 to 40 degrees.…”

Section: Elbow Deformitymentioning

confidence: 99%

Late Reconstruction of Brachial Plexus Birth Palsy

Sibbel¹,

Bauer²,

James³

2014

Journal of Pediatric Orthopaedics

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Brachial plexus birth palsy (BPBP) presents to the physician on a clinical spectrum, and may substantially impair the child. Potential interventions to improve function for the child with BPBP include physical therapy, microsurgical nerve reconstruction and nerve transfers, soft-tissue balancing and reconstruction with musculotendinous transfers, and osteotomies. Some interventions, such as nerve reconstruction, are best performed in infancy; others, such as muscle transfers and osteotomies, are performed to treat manifestations of this condition that appear later in childhood. Although controversy continues to exist regarding the natural history and surgical management of these patients, recent literature has improved our understanding of surgical indications, anticipated outcomes, and potential complications. On the basis of current evidence, we present here the recommendations for surgical intervention in the upper extremity of children with BPBP, and encourage early referral to a brachial plexus specialist to establish care.

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“…However, EFC occurs even in cases without recovery of elbow flexion [11]. Additional hypotheses include: long head of biceps over-activity [12], uncommon C8-T1 pattern injuries [13], presence of shoulder contracture [14], and abnormal posturing [10]. The uncertain aetiology is reflected in the range of proposed treatments: serial casts/splints [8], arthrodiastasis [15], anterior release [16], and muscle lengthening [17].…”

Section: Introductionmentioning

confidence: 99%