Restoration of shoulder motion using single- versus dual-nerve repair in obstetrical brachial plexus injury

Azzi, Alain J.; Alnaeem, Hassan; Aubin-Lemay, Camille; Kvann, Julie; Alam, Peter; Retrouvey, Helene; Aldekhayel, Salah; Zadeh, Teanoosh

doi:10.3171/2017.11.peds17493

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Spearman rank correlation revealed a moderate, negative monotonic correlation (ρ = −0.30, n = 89, p < .01) between increasing age (5.50 ± 2.09 months) and Mallet subscore for hand‐to‐mouth (3.43 ± 0.83) (Blaauw et al, 2006 ; Blaauw & Slooff, 2003 ; Ghanghurde et al, 2016 ; Gibon et al, 2016 ; Malessy & Pondaag, 2014 ; Xu et al, 2000 ). There was no significant correlation between age (6.31 ± 3.33 months) and Mallet subscore for shoulder abduction (3.41 ± 0.82, ρ = −0.09, n = 91, p = .41) (Azzi et al, 2018 ; Blaauw et al, 2006 ; Ghanghurde et al, 2016 ; Gibon et al, 2016 ; Gosk et al, 2010 ; Grossman et al, 2004 ; Malessy & Pondaag, 2014 ; Terzis & Kostas, 2005 ; Terzis & Kostas, 2008 ; Xu et al, 2000 ) or between age (7.92 ± 5.62 months) and MRC subscore for elbow flexion (3.65 ± 0.79, ρ = −0.10, n = 119, p = .29) (Chuang et al, 2005 ; Ghanghurde et al, 2016 ; Gibon et al, 2016 ; Lin et al, 2011 ; Luo et al, 2011 ; Malessy & Pondaag, 2014 ; Meyer, 1986 ; Noaman et al, 2004 ; Siqueira et al, 2012 ; Xu et al, 2000 ). There was also no significant correlation between age (16.85 ± 13.93 months) and AMS subscore for elbow flexion (5.72 ± 1.76, ρ = −0.16, n = 81, p = 1.14) (Al‐Qattan & Al‐Kharfy, 2014 ; Argenta et al, 2016 ; Figueiredo Rde et al, 2016 ; Little et al, 2014 ; Mencl et al, 2015 ; Murison et al, 2017 ; Semaya et al, 2019 ) and between age (10.37 ± 0.82 months) and AMS subscore for external rotation (4.96 ± 1.95, ρ = −0.04, n = 26, p = .84) (Argenta et al, 2016 ; Bade et al, 2014 ; Mencl et al, 2015 ).…”

Section: Resultsmentioning

confidence: 99%

Surgical timing in neonatal brachial plexus palsy: A PRISMA‐IPD systematic review

et al. 2022

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Background Neonatal brachial plexus palsy (NBPP) is a serious complication of high‐risk deliveries with controversy surrounding timing of corrective nerve surgery. This review systematically examines the existing literature and investigates correlations between age at time of upper trunk brachial plexus microsurgery and surgical outcomes. Methods A systematic screening of PubMed, Cochrane, Web of Science, and CINAHL databases using PRISMA‐IPD guidelines was conducted in January 2020 to include full‐text English papers with microsurgery in upper trunk palsy, pediatric patients. Spearman rank correlation analysis and two‐tailed t‐tests were performed using individual patient data to determine the relationship between mean age at time of surgery and outcome as determined by the Mallet, Medical Research Council (MRC), or Active Movement Scale (AMS) subscores. Results Two thousand nine hundred thirty six papers were screened to finalize 25 papers containing individual patient data (n = 256) with low to moderate risk of bias, as assessed by the ROBINS‐I assessment tool. Mallet subscore for hand‐to‐mouth and shoulder abduction, AMS subscore for elbow flexion and external rotation, and MRC subscore for elbow flexion were analyzed alongside the respective age of patients at surgery. Spearman rank correlation analysis revealed a significant negative correlation (ρ = −0.30, p < .01, n = 89) between increasing age (5.50 ± 2.09 months) and Mallet subscore for hand‐to‐mouth (3.43 ± 0.83). T‐tests revealed a significant decrease in Mallet hand‐to‐mouth subscores after 6 months (p < .05) and 9 months (p < .05) of age. No significant effects were observed for Mallet shoulder abduction, MRC elbow flexion, or AMS elbow flexion and external rotation. Conclusion The cumulative evidence suggests a significant negative correlation between age at microsurgery and Mallet subscores for hand‐to‐mouth. However, a similar correlation with age at surgery was not observed for Mallet shoulder abduction, MRC elbow flexion, AMS external rotation, and AMS elbow flexion subscores.

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Section: Resultsmentioning

confidence: 99%

Surgical timing in neonatal brachial plexus palsy: A PRISMA‐IPD systematic review

et al. 2022

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Spinal accessory nerve transfer for shoulder abduction has no benefit over supraclavicular exploration and nerve grafting in brachial plexus birth injury: a systematic review

Mendiratta,

Singh,

Abdelmalek

et al. 2024

Front. Pediatr.

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IntroductionBrachial plexus birth injury (BPBI) has an incidence of 0.9 per 1,000 live births in the population. Techniques for repair classically include supraclavicular exploration and nerve grafting (SENG) and more recently nerve transfer, namely of the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) to improve functional outcomes such as glenohumeral abduction and external rotation. This systematic review was conducted to evaluate whether spinal accessory nerve transfer produced significantly better outcomes for shoulder abduction in BPBI.MethodsA search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Individual Patient Data guidelines. Standardized comparisons were made using the Mallet Score for shoulder abduction.Results10 full-text articles with itemized patient outcome measures were selected. 110 patients were identified with 51 patients in the SENG group and 59 patients in the SAN transfer group. The mean shoulder abduction Mallet score in the SENG group was 3.50 ± 0.84, while the mean Mallet score in the SAN transfer group was 3.58 ± 0.77, which displayed no significant differences (p = 0.9012). There was no significant relationship between the age at time of surgery and post-operative Mallet scores for shoulder abduction after SENG (p = 0.3720).DiscussionOur systematic review found that there was no difference observed in post-operative outcomes of shoulder abduction when comparing SAN transfer and nerve grafting. Continued support for nerve grafting lies in the argument that it incorporates the patient's native neuroanatomy and allows for sensory reinnervation.

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Restoration of shoulder motion using single- versus dual-nerve repair in obstetrical brachial plexus injury

Cited by 2 publications

References 18 publications

Surgical timing in neonatal brachial plexus palsy: A PRISMA‐IPD systematic review

Surgical timing in neonatal brachial plexus palsy: A PRISMA‐IPD systematic review

Spinal accessory nerve transfer for shoulder abduction has no benefit over supraclavicular exploration and nerve grafting in brachial plexus birth injury: a systematic review

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