Limb Length Differences after Obstetrical Brachial Plexus Injury

Bain, James R.; DeMatteo, Carol; Gjertsen, Deborah; Packham, Tara; Galea, Victoria; Harper, Jack

doi:10.1097/prs.0b013e318262f26b

Cited by 26 publications

(25 citation statements)

References 16 publications

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“…It is well known that peripheral nerve injuries experienced in early childhood such as obstetrical brachial plexus palsy, poliomyelitis leads to ipsilateral bone growth failure. [6][7][8]16 Distinct relays from hypothalamus to cells of bone controls activity of osteoblasts and osteoclasts. 17,18 A number of immunochemical studies suggest that the neural control on bone metabolism may be mediated by means of various neurotransmitters released from nerves of bones.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies, using bone length measurement, focused on the bone length retardation of the affected limb in children with obstetrical brachial plexus palsy. [6][7][8] Although longitudinal growth of the skeleton is the most remarkable characteristic of growth during childhood, the development of the skeleton is a complex process that contains radiational growth and specific alterations in the contours of the bones as well as longitudinal growth. Skeletal growth and development occurs by the proliferation and differentiation of chondrocytes at the growth plate (longitudinal growth) and primary and secondary ossification centers (diameter growth) under the control of systemic and local factors.…”

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confidence: 99%

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Bone Age in Children With Obstetrical Brachial Plexus Palsy

Oktay

Cömert²,

Gökkaya³

et al. 2013

J Child Neurol

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The purpose of this retrospective study was to analyze the effect of peripheral nerve injury on the skeletal maturation process. The bone ages of the affected and unaffected hand-wrists of 42 children with obstetrical brachial palsy were determined according to the Greulich and Pyle atlas. In 23 patients, the bone ages of the both sides were identical (bone-age-symmetrical group), in 19 patients the bone age of the affected side was delayed (bone-age-delayed group). The mean bone age of the affected side was delayed 0.48 ± 0.25 years that of the unaffected side (P = .000), and the delay of bone age was inversely correlated with chronological age (R (2) = .45, P < .02) in the bone-age-delayed group. Skeletal retardation can be recognized after appearance of ossification centers by plain radiography, dating from the third month of life, in early infancy. Thus, bone age determination method might be helpful for predicting potential future limb shortness.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Bone Age in Children With Obstetrical Brachial Plexus Palsy

Oktay

Cömert²,

Gökkaya³

et al. 2013

J Child Neurol

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“…Considering radiation in the paediatric population [22], only necessary joints were imaged. At each visit, all patients were assessed with the Active Movement Scale (AMS) [19], measurements of limb length and circumference (arm and forearm) [21], and joint range of motion. Prior to adoption of the AMS, Mallet Classification [23] was used to evaluate outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…Using data from our previous study, sample size calculations were performed for a paired t-test to detect a 2 cm length difference between the biceps on the injured and unaffected arm, standard deviation (SD) = 1.2 cm, alpha = 0.05, and power = 0.80 [21]. Five patients (10 arms) were required.…”

Section: Methodsmentioning

confidence: 99%

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“Popeye muscle” morphology in OBPI elbow flexion contracture

Coroneos¹,

Maizlin²,

DeMatteo³

et al. 2015

Journal of Plastic Surgery and Hand Surgery

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Developing a decision aid for youth with brachial plexus birth injuries facing treatment decisions for an elbow flexion contracture

Parsons

Davidge

et al. 2021

PM&R

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Background A common sequela of brachial plexus birth injury (BPBI) is an elbow flexion contracture. Youth with BPBI and their families face rehabilitation or surgical decisions that ideally entail careful deliberation of the risks and benefits of treatment within the context of the child's and family's functional and appearance‐related goals. Objective To develop a patient decision aid (PtDA) following International Patient Decision Aid Standards to help these youth and their families make treatment decisions. Design Mixed‐methods study. Setting Brachial plexus clinic in a pediatric tertiary care center. Participants Five young adults (21–24 years), 14 youth (8–19 years) and their parents, 15 families (children 2–16 years), and 19 clinicians from a brachial plexus clinic participated in the PtDA development. Seventeen other youth (8–18 years) facing treatment decisions regarding their elbow contracture field tested the PtDA prototype. Interventions Not applicable. Main Outcome Measures In‐depth interviews and participant observation to conduct a decisional needs assessment of young adults, youth, parents, and health care professionals involved in these shared decisions. Cognitive interviews to field test the PtDA prototype. Results Evidence from previously conducted knowledge synthesis and the youth‐focused decisional needs assessment qualitative data informed the development of new PtDA prototype, which included a questionnaire‐based values clarification method for youth to rate what matters most to them regarding their elbow function, appearance, psychosocial impact, and treatment options. The majority (90%) of youth >11 years who field tested the PtDA prototype understood its content, whereas only 29% of those between 8 and 11 years demonstrated independent comprehension. The majority (69%) responded that they would prefer to use the PtDA on their own either at home or in the clinic waiting room. Conclusions This new PtDA can be used to help youth with BPBI and their families to make a personal value‐based informed decision regarding treatment options for their elbow flexion contracture.

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Limb Length Differences after Obstetrical Brachial Plexus Injury

Abstract: Obstetrical brachial plexus injury significantly affects the length of the arm and forearm. Early detectable limb length deficits are associated with the likelihood of requiring surgical reconstruction. Clinical limb length measurement can be performed reliably and noninvasively.

Cited by 26 publications

References 16 publications

Bone Age in Children With Obstetrical Brachial Plexus Palsy

Bone Age in Children With Obstetrical Brachial Plexus Palsy

“Popeye muscle” morphology in OBPI elbow flexion contracture

Developing a decision aid for youth with brachial plexus birth injuries facing treatment decisions for an elbow flexion contracture

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