Late Reconstruction of Brachial Plexus Birth Palsy

Sibbel, Sarah E.; Bauer, Andrea S.; James, Michelle A.

doi:10.1097/bpo.0000000000000290

Cited by 10 publications

(2 citation statements)

References 50 publications

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“…In most cases, BPI is transitory, with complete recovery occurring in 75–95% of cases ( Prigent and Romana, 2013 ; Polcaro et al, 2019 ). However, other recent studies suggest a lower total recovery rate of just 66%, with 20–30% of affected individuals experiencing residual deficits and 10–15% of cases resulting in considerably altered functionality ( Hoeksma et al, 2004 ; Sibbel et al, 2014 ).…”

Section: Introductionmentioning

confidence: 91%

Single Blind Randomized Controlled Trial of Modified Constraint-Induced Movement Therapy in Infants With the Sequelas of Unilateral Brachial Plexus Injury

Cui

Liu²,

Chen

et al. 2022

Front. Hum. Neurosci.

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ObjectiveTo explore the effect of modified constraint-induced movement therapy (mCIMT) on upper limbs residual dysfunction for infancy with the sequelas of unilateral brachial plexus injury (uBPI).MethodsSingle blind randomized controlled trial of mCIMT vs. standard care. An enrolling 31 infants with a uBPI exhibiting residual dysfunction of the affected upper limb for over 6 months was conducted. And functional outcomes pertaining to the affected upper limb were assessed via AMS, GRES, RHS, and MSS at 0, 3, and 6 months after treatment.ResultsNo differences were found in baseline (acquisition phase) AMS, MSS, GRES, or RHS between the control and mCIMT groups [F(1, 14) = 0.062, P = 0.086; F(1, 14) = 0.483, P = 0.499; F(1, 14) = 0.272, P = 0.610; Z = −0.336, P = 7.373]. At the 3- and 6-month follow-up time points, AMS, MSS, and GRES scores were significantly improved over baseline in both groups [mCIMT: F(2, 30) = 183.750, 128.614, 110.085, P < 0.05; Control: F(2, 28) = 204.007, 75.246, 51.070, P < 0.05]. No significant differences were found between two treatment groups at the 3-month follow-up time point [F(1, 14) = 0.565, P = 0.465; F(1, 14) = 0.228, P = 0.641; F(1, 14) = 0.713, P = 0.413; Z = −0.666, P = 0.505]. However, at the 6-month follow-up time point, AMS and MSS scores were significantly improved in the mCIMT group relative to the control group [F(1, 14) = 8.077, P = 0.013; F(1, 14) = 18.692, P = 0.001].ConclusionmCIMT may benefit the rehabilitation of residual upper limb dysfunction associated with a uBPI in infants.Clinical Trial Registration[www.chictr.org.cn], identifier [ChiCTR1900022119].

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Section: Introductionmentioning

confidence: 91%

Single Blind Randomized Controlled Trial of Modified Constraint-Induced Movement Therapy in Infants With the Sequelas of Unilateral Brachial Plexus Injury

Cui

Liu²,

Chen

et al. 2022

Front. Hum. Neurosci.

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“… 17 This causes limitation of external rotation, elevation, and abduction of the arm, resulting in inability to reach face and head in a normal pattern, and “trumpet sign.” 39 The fixed internal rotation deformity and impaired muscle longitudinal growth and imbalance would produce glenohumeral dysplasia (GHD). 7 , 8 , 9 , 10 , 28 , 32 , 36 An early correction of contractures, not only improves appearance of arm and shoulder function but may also prevent dysplasia. 19 , 41 …”

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confidence: 99%

The outcome of soft-tissue release and tendon transfer in shoulders with brachial plexus birth palsy

2021

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Background Shoulder involvement in brachial plexus birth palsy is common, and the adduction, internal rotation contracture deformity often requires some form of surgical treatment. There are very few long-term reports on release of contracted muscles and tendon transfers, especially in older children. We are reporting the single-center results of such a surgery with detailed outcome analysis. Methods The prospectively collected data from brachial plexus birth palsy cases who had undergone contracture release and tendon transfer were retrospectively studied and examined. The new Mallet and functional scores were compared with the original data forms and then analyzed. The radiographic evidence of glenoid dysplasia and its correlation with age and functional outcome was assessed. Results A total of 82 cases with surgery at mean age of 9.5 ± 5.09 years and a follow-up of 8 ± 3.8 (3-20) years entered the study. Of these, 56% of cases had 7 to 20 years of age at surgery. Fifty-four (66%) patients had only shoulder surgery, and 28 (34%) required additional reconstructive surgeries for hand and wrist. Moderate to severe glenohumeral dysplasia was present in 38%. The preoperative Mallet score of 10.6 ± 2.97 improved to 19.3 ± 3.39 ( P < .001). Eighty-one percent of patients showed improvement in “reaching face” functions, 71% in “above head” functions, and 74% in “midline functions.” The cases with lack of improvement in midline function mostly belonged to pan-plexus injuries. Noticeable subjective and objective improvement was also observed in cases with glenohumeral dysplasia in their Mallet and functional scores ( P < .001). The improvement in function and subjective satisfaction of 92% was observed irrespective of age at surgery. Conclusion Soft-tissue release and tendon transfer for brachial plexus birth palsy shoulder can improve function and limb appearance even in older children and young adults and even in the presence of glenohumeral dysplasia.

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Brachial plexus birth palsy: Management during the first year of life

Abid

2016

Orthopaedics & Traumatology: Surgery & Research

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Brachial plexus birth palsy (BPBP) is defined as an injury to any nerve root of the brachial plexus during difficult delivery. BPBP is relatively rare; its incidence has remained constant over the last few decades, mostly due to unpredictable risk factors, such as shoulder dystocia. Both diagnosis and assessment of spontaneous recovery is based on clinical examination. Electromyography is difficult to interpret in the newborn and is therefore not meaningful. MRI of the cervical spine requires sedation or general anesthesia. Searching for a pre-ganglion tear prior to surgery is indicted. Prognosis depends on the level of the injury (pre- or post-ganglion), size and severity of the post-ganglion tears, speed of recovery, and quality of initial management. Although spontaneous recovery is frequent, some children suffer various degrees of sequelae, up to complete loss of function of the affected upper limb. Recent publications have improved general knowledge and indications for surgery. However, some aspects, such as indication and timing of nerve repair continue to be debated.

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Late Reconstruction of Brachial Plexus Birth Palsy

Cited by 10 publications

References 50 publications

Single Blind Randomized Controlled Trial of Modified Constraint-Induced Movement Therapy in Infants With the Sequelas of Unilateral Brachial Plexus Injury

Single Blind Randomized Controlled Trial of Modified Constraint-Induced Movement Therapy in Infants With the Sequelas of Unilateral Brachial Plexus Injury

The outcome of soft-tissue release and tendon transfer in shoulders with brachial plexus birth palsy

Brachial plexus birth palsy: Management during the first year of life

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