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Obstetrical Brachial plexus lesions

Matthias Gmeiner, Raffi Topakian, Manuel Göschl, Sarah Wurm, Anita Holzinger, Willem J R van Ouwerkerk, Kurt Holl
PURPOSE: An accessory to suprascapular nerve (XIN-SSN) transfer is considered in patients with obstetric brachial plexus lesion who fail to recover active shoulder external rotation. The aim of this study was to evaluate the quality of extraplexal suprascapular nerve neurotization and to perform a detailed analysis of the infraspinatus muscle (IM) and shoulder external rotation. METHODS: A XIN-SSN transfer was performed in 14 patients between 2000 and 2007. Patients had been operated at the age of 3...
September 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Feng Pan, Liang Chen, Fei Ding, Jie Zhang, Yu-Dong Gu
Clinically in obstetric brachial plexus palsy (OBPP), irreversible atrophy of intrinsic musculature of the hand in denervation occurs much earlier than that of denervated arm muscles. With the aim of finding clues to explain this, the miRNA expression profile of denervated intrinsic musculature of the forepaw (IMF) and that of the denervated biceps were examined by microarray screening in the rat model simulating irreversible muscular atrophy caused by pan-plexus lesions of OBPP, and potential targets of specifically dysregulated miRNAs were predicted with use of bioinformatics analysis...
July 10, 2015: Gene
Conny de Heer, Heleen Beckerman, Vincent de Groot
PURPOSE: To study the influence of obstetric brachial plexus lesion (OBPL) on arm-hand function and daily functioning in adults, and to investigate the relationship of arm-hand function and pain to daily functioning. METHOD: Adults with unilateral OBPL who consulted the brachial plexus team at the VU University Medical Center in the past were invited to participate. Daily functioning was measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and the SF36, pain with VAS Pain Scales and arm-hand function with the Nine Hole Peg Test (9-HP-test) and the Action Research Arm Test (ARAT)...
2015: Disability and Rehabilitation
Julia K Terzis, Dimitrios Karypidis, Ricardo Mendoza, Zinon T Kokkalis, Norou Diawara
BACKGROUND: Scapular position and size deficiency is evident in obstetric brachial plexus paralysis (OBPP) patients due to the absence of balanced muscular forces acting on the scapula. Scapula stabilization (SS) procedures aim to restore a balanced musculature and anatomic position and to augment shoulder function and enhance developmental potential. METHODS: Retrospective chart review of 106 patients with OBPP between March 1979 and March 2007 was performed. Forty-one female and 27 male were included in the study...
September 2014: Hand: Official Journal of the American Association for Hand Surgery
Virginia Simson Nelson
No abstract text is available yet for this article.
October 2014: Developmental Medicine and Child Neurology
Galia V Anguelova, Martijn J A Malessy, Erik W van Zwet, J Gert van Dijk
AIM: The aim of this cross-sectional study was to assess systematically motor function and motor misrouting in adults with conservatively treated obstetric brachial plexus lesion (OBPL). METHOD: Seventeen adults with OBPL (median age 38y; five males, 12 females) and 16 comparison participants (median age 26y; eight males, eight females) were investigated. Motor function in the group with OBPL was assessed through passive and active motion, muscle strength of the deltoid, biceps, and triceps muscles, and Mallet aggregate score and five subscores...
October 2014: Developmental Medicine and Child Neurology
Jerzy Gosk, Witold Wnukiewicz, Maciej Urban
BACKGROUND: Deficiency 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. METHODS: Forty-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...
2014: BMC Musculoskeletal Disorders
Claudia Romana, Emmanuel Gibon, Raphaël Vialle
BACKGROUND: C5-C6 root avulsion in obstetrical brachial plexus palsy (OBPP) is a rare injury with poor prognosis usually associated with breech delivery. The treatment is challenging and requires high microsurgical skills. The triple nerve transfer (spinal accessory nerve, ulnar fascicles, and triceps long or lateral head branch) represents the gold standard treatment. The total ipsilateral C7 nerve root neurotization is a promising technique, which has never been described in OBPP. OBJECTIVE: The total ipsilateral C7 nerve root is used as a neurotizer transferred to the upper trunk as an alternative method to other intra- or extra-plexual reconstruction techniques...
May 2014: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jiří Chomiak, Pavel Dungl, Martin Ošťádal, Monika Frydrychová, Michal Burian
PURPOSE: Latissimus dorsi and teres major transfers to the lateral side of the humerus with lengthening of the pectoralis major and subscapularis muscles for residual shoulder deformity were compared in children and skeletally mature patients. METHODS: Fifteen patients (nine children, six skeletally mature patients aged three to 30 years, follow-up one to 22 years) were treated for internal shoulder contracture after birth plexus lesions: C5-C6 (seven patients); C5-7 (five patients); C5-C8-T1 (three patients, respectively)...
April 2014: International Orthopaedics
W Pondaag, M J A Malessy
In obstetric brachial plexus lesions with avulsion injury, nerve grafting for biceps muscle re-innervation may not be possible owing to the unavailability of a proximal stump. In such cases, the intercostal nerves or medial pectoral nerve can serve as donor nerves in an end-to-end transfer to the musculocutaneous nerve. The present study reports the results of both techniques from a single institution in a consecutive series of 42 patients between 1995 and 2008. From 1995 to 2000 we always used the intercostal nerve transfer, and from 2001 to 2008 both techniques were used...
July 2014: Journal of Hand Surgery, European Volume
Rahul K Nath, Nirupuma Kumar, Chandra Somasundaram
BACKGROUND: Nerve conduction studies or somatosensory evoked potentials (SSEPs) have become an important tool in the investigation of peripheral nerve lesions, and is sensitive in detecting brachial plexus nerve injury, and other nerve injuries. To investigate whether the modified Quad surgical procedure improves nerve conductivity and functional outcomes in obstetric brachial plexus nerve injury (OBPI) patients. METHODS: All nerves were tested with direct functional electrical stimulation...
2013: Annals of Surgical Innovation and Research
K F Chin, V P Misra, G M Sicuri, M Fox, M Sinisi
We investigated the predictive value of intra-operative neurophysiological investigations in obstetric brachial plexus injuries. Between January 2005 and June 2011 a total of 32 infants of 206 referred to our unit underwent exploration of the plexus, including neurolysis. The findings from intra-operative electromyography, sensory evoked potentials across the lesion and gross muscular response to stimulation were evaluated. A total of 22 infants underwent neurolysis alone and ten had microsurgical reconstruction...
May 2013: Bone & Joint Journal
M C Romaña, A Rogier
Obstetrical brachial plexus palsy is considered to be the result of a trauma during the delivery, even if there remains some controversy surrounding the causes. Although most babies recover spontaneously in the first 3 months of life, a small number remains with poor recovery which requires surgical brachial plexus exploration. Surgical indications depend on the type of lesion (producing total or partial palsy) and particularly the nonrecovery of biceps function by the age of 3 months. In a global palsy, microsurgery will be mandatory and the strategy for restoration will focus first on hand reinnervation and secondarily on providing elbow flexion and shoulder stability...
2013: Handbook of Clinical Neurology
Valerie M van Gelein Vitringa, Barend J van Royen, Johannes A van der Sluijs
BACKGROUND: The Hueter-Volkmann law describes growth principles around joints and joint deformation. It states that decreased stress leads to increased growth and that excessive stress leads to growth retardation. Aim of this study was to test the possible results of this principle by measuring the effect of dorsal humeral head subluxation on scapular growth in children with Obstetrical Brachial Plexus Lesions (OBPL). According to the Hueter-Volkmann law, subluxation should result in decrease of growth of the dorsal length of the scapula (by increased dorsal pressure) and increase of the ventral length (decreased pressure)...
2013: BMC Musculoskeletal Disorders
I De Kock, L Jans, K Verstraete
Brachial plexus injury is the most common cause of plegic arm in neonates. Detection of nerve root avulsions and intraspinal nerve lesions is most valuable for treatment strategy. Magnetic resonance imaging (MRI) is the modality of choice for imaging the brachial plexus in infants as it allows visualization and localization of different types of nerve lesions in a noninvasive way and without radiation exposure. Conventional radiography of the shoulder is of interest in follow-up to assess osseous deformities of the glenoid fossa and humeral head...
September 2012: JBR-BTR: Organe de la Société Royale Belge de Radiologie (SRBR)
Mary Galea
No abstract text is available yet for this article.
March 2013: Developmental Medicine and Child Neurology
S Collado-Vazquez, C Jimenez-Antona, J M Carrillo
INTRODUCTION: Lesions of the peripheral nerves have been known since ancient times, but there are few references to the treatments that were used in the past. AIM. To analyse obstetric brachial palsy and its treatments throughout history. DEVELOPMENT: There are a number of different references to the peripheral nerves and their lesions, although little is known about the treatments that were applied in the past. William Smellie first reported obstetric brachial palsy in 1764 and the term was coined by Duchenne de Boulogne in 1872...
November 16, 2012: Revista de Neurologia
Galia V Anguelova, Martijn J A Malessy, J Gert Van Dijk
AIM: Sensory function is assumed to recover almost completely in obstetric brachial plexus lesion (OBPL), and is reported to recover much better than motor function. However, there is no obvious physiological reason why this should be so. Any persistent problems with sensory innervation might contribute to disability, therefore we aimed to assess sensory dysfunction in adults resulting from OBPL. METHOD: Adults with conservatively treated OBPL (n=17; 12 females, five males; median age 38y; lesion levels: C5-C6, n=7; C5-C7, n=7; C5-C8, n=2; C5-Th1, n=1) and 19 healthy comparison persons (10 females, nine males; median age 23y) were investigated...
March 2013: Developmental Medicine and Child Neurology
Johanna M Ruoff, Johannes A van der Sluijs, Willem J van Ouwerkerk, Richard T Jaspers
AIM: Denervation after obstetric brachial plexus lesion (OBPL) is associated with reduced musculoskeletal growth in the upper arm. The aim of this study was to investigate whether reduced growth of upper arm flexor and extensor muscles is related to active elbow function and humeral length. METHOD: In this study, 31 infants age less than 6 months (mean age 4.3mo; range 2.1-5.9mo; 17 males; 14 females;) with unilateral OBPL (Narakas class I, 19; II, 3; III, 2; and IV, 7) treated at the VU medical centre, in whom neurosurgical reconstruction was considered were prospectively studied using magnetic resonance imaging of both arms at a mean age of 4...
November 2012: Developmental Medicine and Child Neurology
Sonja Buitenhuis, Rietje S van Wijlen-Hempel, Willem Pondaag, Martijn J A Malessy
AIMS: First, to assess whether children with an Obstetric Brachial Plexus Lesion (OBPL) have a higher incidence of Central Developmental Disability (CDD) compared to the general population. Second, to test the ability of General Movements (GMs) to identify CDD children already at three months of age. STUDY DESIGN: A prospective cohort study for infants referred to our tertiary nerve lesion clinic. SUBJECTS: A prospective cohort study of 38 infants with OBPL followed until 5 years (mean age)...
September 2012: Early Human Development
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