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Obstetrical brachial plexus palsy

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https://www.readbyqxmd.com/read/29134042/direct-nerve-sutures-in-extended-upper-obstetric-brachial-plexus-repair
#1
J Bahm, A Gkotsi, S Bouslama, W El-Kazzi, F Schuind
Background  In rare, selected cases of severe (extended) upper obstetric brachial plexus palsy (OBPP), after supraclavicular exposure and distal mobilization of the traumatized trunks and careful neuroma excision, we decided to perform direct nerve coaptation with tolerable tension and immobilized the affected arm positioned in adduction and 90-degree elbow flexion for three weeks. Objectives  We present our surgical technique and preliminary results in a prospective open patient series, including 22 patients (14 right and 8 left side affected) between 2009 and 2016, operated at a mean age of 8...
January 2017: Journal of Brachial Plexus and Peripheral Nerve Injury
https://www.readbyqxmd.com/read/29092081/novel-findings-in-obstetric-brachial-plexus-palsy-a-study-of-corpus-callosum-volumetry-and-resting-state-functional-magnetic-resonance-imaging-of-sensorimotor-network
#2
Kishore Kislay, Bhagavatula Indira Devi, Dhananjaya Ishwar Bhat, Dhaval Prem Shukla, Arun Kumar Gupta, Rajanikant Panda
BACKGROUND: The response of the brain to obstetric brachial plexus palsy (OBPP) is not clearly understood. We propose that even a peripheral insult at the developmental stage may result in changes in the volume of white matter of the brain, which we studied using corpus callosum volumetry and resting-state functional magnetic resonance imaging (rsfMRI) of sensorimotor network. OBJECTIVE: To study the central neural effects in OBPP. METHODS: We performed an MRI study on a cohort of 14 children who had OBPP and 14 healthy controls...
October 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29016426/the-epidemiology-of-brachial-plexus-birth-palsy-in-the-united-states-declining-incidence-and-evolving-risk-factors
#3
Christopher J DeFrancesco, Divya K Shah, Benjamin H Rogers, Apurva S Shah
BACKGROUND: The epidemiology of brachial plexus birth palsy (BPBP) in the United States may be changing over time due to population-level changes in obstetric care. METHODS: The Kids' Inpatient Database from 1997 to 2012 was analyzed. Annual estimates of BPBP incidence and disease determinant distribution were calculated for the general population and the study population with BPBP. Long-term trends were analyzed. A multivariate logistic regression model was used to quantify the risk associated with each determinant...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28989239/scarring-of-the-c8-t1-roots-with-partial-avulsion-in-situ-in-total-obstetric-brachial-plexus-palsy
#4
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
https://www.readbyqxmd.com/read/28798538/the-outcome-of-primary-brachial-plexus-reconstruction-in-extended-erb-s-obstetric-palsy-when-two-roots-are-available-for-intraplexus-neurotization
#5
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: The outcome of primary brachial plexus reconstruction in extended Erb's obstetric palsy with single root avulsion has not been specifically documented in the literature. METHODS: A series of 46 consecutive cases of extended Erb's obstetric palsy with single root avulsion was retrospectively reviewed. The upper and middle trunks were reconstructed with nerve grafts from the available two roots. No nerve transfers were used. The percentage of a satisfactory motor recovery was documented...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28798537/the-outcome-of-primary-brachial-plexus-reconstruction-in-extended-erb-s-obstetric-palsy-when-only-one-root-is-available-for-intraplexus-neurotization
#6
Mohammad M Al-Qattan, Amel Ahmed F El-Sayed
BACKGROUND: A recent review by the International Federation of Societies for Surgery of the Hand showed no studies comparing the results of nerve grafting to distal nerve transfer for primary reconstruction of the brachial plexus in infants with obstetric brachial plexus palsy (OBBP). The aim of this retrospective study is to compare two surgical reconstructive strategies in primary reconstruction of the brachial plexus in extended Erb's obstetric palsy with double root avulsion: one with and one without distal nerve transfer for elbow flexion...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28783492/shoulder-muscle-atrophy-and-its-relation-to-strength-loss-in-obstetrical-brachial-plexus-palsy
#7
Christelle Pons, Frances T Sheehan, Hyun Soo Im, Sylvain Brochard, Katharine E Alter
BACKGROUND: Treatment/prevention of shoulder muscle strength imbalances are major therapeutic goals for children with obstetrical brachial plexus palsy. The study aims were to characterize muscle atrophy in children/adolescents with unilateral obstetrical brachial plexus palsy, to quantify the agonist-antagonist muscle volume balance and the association between muscle volume and strength. METHODS: Eight boys and four girls (age=12.1, standard deviation=3.3) participated in this case-control study...
October 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28719548/forearm-pronation-osteotomy-for-supination-contracture-secondary-to-obstetrical-brachial-plexus-palsy-a-retrospective-cohort-study
#8
Aharon Z Gladstein, Brant Sachleben, Emily S Ho, Alison Anthony, Howard M Clarke, Sevan Hopyan
BACKGROUND: Obstetrical brachial plexus palsy can lead to fixed forearm supination contracture. Fixed supination may lead to functional deficits as the affected hand cannot be positioned optimally for activities on a desk such as writing and typing, or for using tools including utensils, which require a neutral or pronated forearm. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not been clearly defined...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28709767/obstetrical-brachial-plexus-palsy
#9
Patricia O'Berry, Mackenzie Brown, Leslie Phillips, Sarah Helen Evans
Obstetrical brachial plexus palsy is a disorder of the peripheral nervous system and occurs in as many as 0.4% of infants born. It is associated with shoulder dystocia, use of mechanical extraction, and macrosomia; it occurs more frequently in infants born by vaginal delivery. The unilateral injury to the brachial plexus complex occurs during the delivery phase as lateral traction is applied to the head to permit shoulder clearance. The infant typically presents in the delivery room with decreased active movements of the affected arm and asymmetrical primitive reflex responses...
July 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28650063/-obstetric-brachial-plexus-palsy-incidence-monitoring-of-progress-and-prognostic-factors
#10
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
https://www.readbyqxmd.com/read/28596982/evidence-of-the-effectiveness-of-primary-brachial-plexus-surgery-in-infants-with-obstetric-brachial-plexus-palsy-revisited
#11
Amel A F El-Sayed
A recent systematic review questioned the effectiveness of primary surgery in infants with obstetric brachial plexus palsy. At our center, the indication for primary surgery in infants with upper Erb's obstetric palsy is the lack of active elbow flexion at age 4 months. The current study compares the outcome of motor recovery in 2 groups of infants with upper Erb's palsy: one group (n = 9) treated surgically between age 4 and 5 months, and another group (n = 9) treated conservatively despite the lack of active elbow flexion at age 4 months...
January 2017: Child neurology open
https://www.readbyqxmd.com/read/28574948/five-operations-that-give-the-best-results-after-brachial-plexus-injury
#12
Andrés A Maldonado, Allen T Bishop, Robert J Spinner, Alexander Y Shin
Treatment of brachial plexus injuries has improved slowly over the past 45 years. Changes in strategy, techniques, microsurgical equipment, and technology have expanded the surgical options for reconstructing these life-altering, highly complex injuries. The surgical techniques available include neurolysis, nerve repair, nerve grafting, nerve transfers, tendon transfer, muscle transfer, and other soft- and bony-tissue procedures. In this article, the authors have selected five surgical procedures (i.e., Oberlin procedure, Leechavengvongs procedure, free functional muscle transfer, radial nerve tendon transfers, and C5-C6 nerve grafting in obstetric birth palsy) that have consistently yielded good results in patients who require surgical reconstruction...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28504029/obstetric-brachial-plexus-palsy-a-population-based-retrospective-case-control-study-and-medicolegal-considerations
#13
Simona Zaami, Francesco Paolo Busardò, Fabrizio Signore, Nicola Felici, Vito Briganti, Giovanni Baglio, Enrico Marinelli, Vittorio Fineschi
AIMS: The aim of this study was to examine 24 cases of obstetric brachial plexus palsy (OBPP) in 41,002 deliveries occurred at San Camillo-Forlanini Hospital in Rome, during the period 2000-2012. MATERIALS AND METHODS: A population-based retrospective case-control study was designed and the database of the hospital was searched; for each case, maternal and fetal records were examined and some risk factors were evaluated. RESULTS: A statistically significant association between the 24 cases OBPP and the following risk factors: primiparity (p < ...
May 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28495173/late-treatment-of-obstetrical-brachial-plexus-palsy-by-humeral-rotational-osteotomy-and-lengthening-with-an-intramedullary-elongation-nail
#14
Ahmet Emrah Acan, Onur Gursan, Nihat Demirhan Demirkiran, Hasan Havitcioglu
To date, all the authors who have recommended external rotation osteotomy (ERO) in the late treatment of obstetrical brachial plexus palsy (OBPP), have neglected upper limb length discrepancy, which is an another sequelae of OBPP. In this paper, a new technique is reported for the late treatment of OBPP patients with upper limb length discrepancy, in which both humeral external rotation osteotomy (ERO) and lengthening are applied with an intramedullary elongation nail. With this technique, upper limb function is improved through re-orientation of the shoulder arc to a more functional range, and further improvements will be seen in the appearance of the upper limb with the elimination of length discrepancy...
May 8, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28472739/inter-joint-coordination-analysis-of-reach-to-grasp-kinematics-in-children-and-adolescents-with-obstetrical-brachial-plexus-palsy
#15
Christian H Mayfield, Sahana N Kukke, Sylvain Brochard, Christopher J Stanley, Katharine E Alter, Diane L Damiano
BACKGROUND: Obstetrical brachial plexus palsy is a common birth injury to nerves passing through the brachial plexus that may result in structural and functional abnormalities. Individual joint trajectories from kinematic analyses have been used to evaluate the source and extent of abnormalities. Here, two summary measures of limb kinematics were utilized: 1) the Arm Profile Score summarizing upper limb joint kinematic abnormalities from a typical pattern across a task, and 2) the recently developed Multi-joint Coordination Measure using principal component analysis to characterize typical coordination of multiple joints throughout a task and compute deviations in time and space...
April 25, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28442854/biceps-rerouting-after-forearm-osteotomy-an-effective-treatment-strategy-for-severe-supination-deformity-in-obstetric-plexus-palsy
#16
W P Metsaars, M Biegstraaten, R G H H Nelissen
Study Design Retrospective cohort study. Objective Supination deformity in obstetric brachial plexus injury can have debilitating consequences for the functionality of the hand. Surgical treatment by a forearm osteotomy has a recurrence rate of 20 to 42%. As a complement to forearm osteotomy, a biceps rerouting may improve outcome. Methods Children with residual brachial plexus injury, who had a forearm osteotomy for a supination contracture and had a postoperative decrease of pronation to 50 degrees or less, were indicated for a biceps rerouting...
April 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28347577/utility-of-ultrasound-guided-injection-of-botulinum-toxin-type-a-for-muscle-imbalance-in-children-with-obstetric-brachial-plexus-palsy-description-of-the-procedure-and-action-protocol
#17
A García Ron, R Gallardo, B Huete Hernani
INTRODUCTION: Obstetric brachial plexus palsy (OBPP) usually has a favourable prognosis. However, nearly one third of all severe cases have permanent sequelae causing a high level of disability. In this study, we explore the effectiveness of ultrasound-guided injection of botulinum toxin A (BoNT-A) and describe the procedure. PATIENTS AND METHODS: We designed a prospective, descriptive study including patients with moderate to severe OBPP who were treated between January 2010 and December 2014...
March 24, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28161491/shoulder-and-elbow-kinematics-during-the-mallet-score-in-obstetrical-brachial-plexus-palsy
#18
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
https://www.readbyqxmd.com/read/28140349/reliability-of-3d-upper-limb-motion-analysis-in-children-with-obstetric-brachial-plexus-palsy
#19
Judy Mahon, Ailish Malone, Damien Kiernan, Dara Meldrum
Kinematics, measured by 3D upper limb motion analysis (3D-ULMA), can potentially increase understanding of movement patterns by quantifying individual joint contributions. Reliability in children with obstetric brachial plexus palsy (OBPP) has not been established. OBJECTIVE: This study aimed to determine between session reliability and measurement errors of 3D-ULMA using the acromion method (AM) in children with OBPP. APPROACH: Ten participants (mean 10 years, range 7-15 years, Narakas classification I-III) completed 3D-ULMA on two occasions, mean interval of 8...
January 31, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/27900273/improvements-after-mod-quad-and-triangle-tilt-revision-surgical-procedures-in-obstetric-brachial-plexus-palsy
#20
Rahul K Nath, Chandra Somasundaram
AIM: To compare outcomes of our revision surgical operations in obstetric brachial plexus palsy (OBPP) patients to results of conventional operative procedures at other institutions. METHODS: We analyzed our OBPP data and identified 10 female and 10 male children aged 2.0 to 11.8 years (average age 6.5 years), who had prior conventional surgical therapies at other clinics. Of the 20 patients, 18 undergone triangle tilt, 2 had only mod Quad. Among 18 patients, 8 had only triangle tilt and 10 had also mod Quad as revision surgeries with us...
November 18, 2016: World Journal of Orthopedics
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