Bone Discrepancy as a Powerful Indicator for early Surgery in Obstetric Brachial Plexus Palsy

Terzis, Julia K.; Kokkalis, Zinon T.

doi:10.1007/s11552-010-9270-z

Cited by 17 publications

(19 citation statements)

References 48 publications

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“…Growth discrepancy is limited with nerve repair, and correlates with impairment. 89 Timing of outcome assessment was not discussed in reviews. In the meta-analysis of primary management, outcomes were measured until at least 2 years of age for non-operative management, or 2 years following operative management.…”

Section: Resultsmentioning

confidence: 99%

Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline

et al. 2017

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ObjectiveThe objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of expertise.SettingThe guideline is intended for all healthcare providers treating infants and children, and all specialists treating upper extremity injuries.ParticipantsThe evidence interpretation and recommendation consensus team (Canadian OBPI Working Group) was composed of clinicians representing each of Canada's 10 multidisciplinary centres.Outcome measuresAn electronic modified Delphi approach was used for consensus, with agreement criteria defined a priori. Quality indicators for referral to a multidisciplinary centre were established by consensus. An original meta-analysis of primary nerve repair and review of Canadian epidemiology and burden were previously completed.Results7 recommendations address clinical gaps and guide identification, referral, treatment and outcome assessment: (1) physically examine for OBPI in newborns with arm asymmetry or risk factors; (2) refer newborns with OBPI to a multidisciplinary centre by 1 month; (3) provide pregnancy/birth history and physical examination findings at birth; (4) multidisciplinary centres should include a therapist and peripheral nerve surgeon experienced with OBPI; (5) physical therapy should be advised by a multidisciplinary team; (6) microsurgical nerve repair is indicated in root avulsion and other OBPI meeting centre operative criteria; (7) the common data set includes the Narakas classification, limb length, Active Movement Scale (AMS) and Brachial Plexus Outcome Measure (BPOM) 2 years after birth/surgery.ConclusionsThe process established a new network of opinion leaders and researchers for further guideline development and multicentre research. A structured referral form is available for primary care, including referral recommendations.

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Section: Resultsmentioning

confidence: 99%

Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline

et al. 2017

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“…The majority of cases achieve a satisfactory recovery without surgical intervention [8,13] and, in particular, in cases of upper injuries of brachial plexus [5,6]. However, in total palsies, the spontaneous reinnervation may be significantly limited [6,8-10,13].…”

Section: Discussionmentioning

confidence: 99%

“…In the last ten years, only three articles were published on the subject in English language journals [10,12,13]. Each of these studies have had a retrospective nature and analysed homogenous group of patients.…”

Section: Discussionmentioning

confidence: 99%

The effect of perinatal brachial plexus lesion on upper limb development

Gosk

Wnukiewicz

Urban

2014

BMC Musculoskelet Disord

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BackgroundDeficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development.MethodsForty-four patients with unilateral obstetric brachial plexus palsy underwent measurements of both upper extremities. The average age at the time of evaluation was 6.8 years. Active motion was assessed using Gilbert-Raimondi, the modified MRC, and Al-Qattan scales. Paired t test was used for statistical analysis. Correlation between limb length / circumference discrepancy and age / time of surgery was assessed using Pearson correlation coefficient.ResultsA decrease in the circumference and length was observed in all limbs with brachial plexus lesion. We found a statistically significant difference between degree of hand length and width decrease and its useful and useless function. We observed a statistically significant difference in measurement: forearm length, hand length and width dependent on the type of surgical procedure (neurolysis, reconstruction). We observed no correlation between age and limb length / circumference discrepancy. We also observed no correlation between time of surgery and limb length / circumference discrepancy.ConclusionsThe decrease in dimensions of the affected limbs occurred predominantly during the period of early childhood. Disparities in dimensions are observed in both cases of deficiency of useful function of upper limb and cases in which functional efficiency appears.

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“…And muscle imbalances and contractures can lead to a lot of bony deformities [3]. In addition, bony deformities can also result from decreased innervation from the brachial plexus to shoulder joint bones [4,5].…”

Section: Introductionmentioning

confidence: 99%

Bidirectional Double Muscle Transfer to Restore Shoulder Abduction and External Rotation in Late Obstetric Brachial Plexus Injuries

Ahmad¹

2014

Surgery Curr Res

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Bone Discrepancy as a Powerful Indicator for early Surgery in Obstetric Brachial Plexus Palsy

Cited by 17 publications

References 48 publications

Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline

Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline

The effect of perinatal brachial plexus lesion on upper limb development

Bidirectional Double Muscle Transfer to Restore Shoulder Abduction and External Rotation in Late Obstetric Brachial Plexus Injuries

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