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Obstetrical Brachial plexus lesions

Maher Barsaoui, Hatem Safi, Walid Said, Med Nabil Nessib
BACKGROUND: Obstetric brachial plexus palsy aredue to elongation of the brachial plexus during delivery by increasing thedistance between the head and shoulder. The majority of paralysis recoverspontaneously, but in some cases, nerve repair is necessary. The timing of thisnerve surgery and criteria for its indication are topics of discussion in theworld literature.The aim of this study is to askdirections and to evaluate the contribution of nerve surgery in improving theprognosis of this disease...
March 2017: La Tunisie Médicale
Yussef Ali Abdouni, Gabriel Faria Checoli, Valdênia das Graças Nascimento, Antonio Carlos da Costa, Ivan Chakkour, Patricia Maria de Moraes Barros Fucs
OBJECTIVE: To evaluate the arc of forearm pronosupination of patients with sequelae of birth paralysis and correlate with these variables. METHODS: 32 children aged between 4 and 14 years with total or partial lesions of the brachial plexus were evaluated; measurements of pronation and supination, active and passive, were made, both on the injured side and the unaffected side. RESULTS: A statistically significant difference was observed between the injured side and the normal side, but there was no difference between the groups regarding age or type of injury...
September 2017: Revista Brasileira de Ortopedia
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach. METHODS: A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots)...
2017: European Journal of Plastic Surgery
Galia V Anguelova, Erwin de Vlugt, Alistair N Vardy, Erik W van Zwet, J Gert van Dijk, Martijn J A Malessy, Jurriaan H de Groot
We suggest short range stiffness (SRS) at the elbow joint as an alternative diagnostic for EMG to assess cocontraction. Elbow SRS is compared between obstetric brachial plexus lesion (OBPL) patients and healthy subjects (cross-sectional study design). Seven controls (median 28years) and five patients (median 31years) isometrically flexed and extended the elbow at rest and three additional torques [2.1,4.3,6.4Nm] while a fast stretch stimulus was applied. SRS was estimated in silico using a neuromechanical elbow model simulating the torque response from the imposed elbow angle...
October 3, 2017: Journal of Biomechanics
Jerzy Luszawski, Wiesław Marcol, Marek Mandera
Most of the cases of obstetric brachial plexus lesions (OBPL) show satisfactory improvement with conservative management, but in about 25% some surgical treatment is indicated. The present paper analyzes the effects of primary reconstructive surgeries in aspect of achieving delineated intraoperatively goals. Children operated before the age of 18 months with follow-up period longer than 1 year were selected. Therapeutic goals established during the operation were identified by analysis of initial clinical status and operative protocols...
September 2017: Neurologia i Neurochirurgia Polska
G Vaquero, A Ramos, J C Martinez, P Valero, N Nunez-Enamorado, R Simon-De Las Heras, A Camacho-Salas
INTRODUCTION: Obstetric brachial plexus palsy is related with shoulder dystocia, and its main risk factor is macrosomia. Its incidence is estimated to be between 0.1 and 6.3 cases per 1,000 live newborn infants. Most cases are resolved but can give rise to permanent functional deficiency, which means that there is an interest to identify possible prognostic factors. PATIENTS AND METHODS: We conducted a descriptive study of newborn infants with obstetric brachial plexus palsy born in our hospital between the years 2011 and 2015...
July 1, 2017: Revista de Neurologia
Lars H Frich, Pernille H Schmidt, Trine Torfing
BACKGROUND: Obstetric brachial plexus lesion (OBPL) frequently leads to glenohumeral dysplasia, and excessive retroversion of the glenoid is among the best known developmental disturbances. Most analyses of the glenoid are based on 2-dimensional (D) imaging and do not address glenoid inclination or provide information on the glenoid in the sagittal plane. We aim to describe the 3-D deformity of the glenoid in children with OBPL. METHODS: Preoperative computed tomography (CT) scans of the nonaffected and the affected scapula of 24 children (aged 5 to 12 years) with developmental disturbances after OBPL years were analyzed...
August 2017: Journal of Shoulder and Elbow Surgery
Olivier Herisson, Nathalie Maurel, Amadou Diop, Morgane Le Chatelier, Adeline Cambon-Binder, Franck Fitoussi
BACKGROUND: The physical signs of obstetrical brachial plexus palsy range from temporary upper-limb dysfunction to a lifelong impairment and deformity in one arm. The aim of this study was to analyze the kinematics of the upper limb and to evaluate the contribution of glenohumeral and scapulothoracic joints of obstetrical brachial plexus palsy children. METHODS: Six children participated in this study: 2 males and 4 females with a mean age of 11.7years. Three patients had a C5, C6 lesion and 3 had a C5, C6, C7 lesion...
March 2017: Clinical Biomechanics
Yasser A Safoury, Mohamed T Eldesoky, Enas E Abutaleb, Mohamed R Atteya, Ahmed M Gabr
BACKGROUND: The transfer of latissimus dorsi and teres major tendons to rotator cuff have been developed to rebalance the muscular dysfunction and improve shoulder range of motion in children with obstetrical brachial plexus palsy (OBPP). No previous study reported the ideal postoperative physical therapy program for these cases. AIM: The aim of the present study was to design appropriate postoperative physical therapy (PT) program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP to improve upper limb function...
April 2017: European Journal of Physical and Rehabilitation Medicine
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
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