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Obstetrical brachial plexus palsy

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https://www.readbyqxmd.com/read/27900273/improvements-after-mod-quad-and-triangle-tilt-revision-surgical-procedures-in-obstetric-brachial-plexus-palsy
#1
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
https://www.readbyqxmd.com/read/27830921/post-operative-physical-therapy-program-for-latissimus-dorsi-and-teres-major-tendons-transfer-to-rotator-cuff-in-children-with-obstetrical-brachial-plexus-injury
#2
Yasser A Safoury, Mohamed Eldesoky, Enas E Abutaleb, Mohamed Raafat, Ahmed M Gaber
BACKGROUND: The transfer 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...
November 10, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27784179/neonatal-brachial-plexus-palsy-obstetric-factors-associated-with-litigation
#3
Suneet P Chauhan, Kate W-C Chang, Nana-Ama Esi Ankumah, Lynda J-S Yang
OBJECTIVE: Our objective was to compare characteristics between neonatal brachial plexus palsy (NBPP) cases that were litigated versus those that were not. STUDY DESIGN: From May to December 2012, the University of Michigan Interdisciplinary Brachial Plexus Program surveyed 51 consecutive families whose children were treated for NBPP. Obstetric data was self-reported. Unless NBPP resolved, children were followed for at least two years. Student's t-test and Chi-square test with odds ratio and 95% confidence intervals were calculated...
November 16, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27763629/risk-factors-for-persistent-disability-in-children-with-obstetric-brachial-plexus-palsy
#4
S Zuarez-Easton, N Zafran, G Garmi, J Hasanein, S Edelstein, R Salim
OBJECTIVE: Obstetric brachial plexus palsy (OBPP) at birth, is a serious neurologic injury that may lead to a long lasting disability. We aimed to examine the occurrence and risk factors associated with disability lasting >1 year. STUDY DESIGN: A retrospective cohort study conducted between 1993 and 2012 included individuals with diagnosis of OBPP at birth. Affected individual's motor function was evaluated by a direct physical exam based on a muscle grading system of the limb, shoulder, elbow and hand...
October 20, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27749670/atlantoaxial-rotatory-subluxation-a-review-for-the-pediatric-emergency-physician
#5
Merritt D Kinon, Rani Nasser, Jonathan Nakhla, Rupen Desai, Jessica R Moreno, Reza Yassari, Carlos A Bagley
Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initiation of treatment have a greater chance of treatment success for the patient. However, timely treatment is complicated because torticollis can result from a variety of maladies, including: congenital abnormalities involving the C1-C2 joint or the surrounding supporting muscles and ligaments, central nervous system abnormalities, obstetric palsies from brachial plexus injuries, clavicle fractures, head and neck surgery, and infection...
October 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27692236/-palsy-of-the-upper-limb-obstetrical-brachial-plexus-palsy-arthrogryposis-cerebral-palsy
#6
B Salazard, C Philandrianos, B Tekpa
"Palsy of the upper limb" in children includes various diseases which leads to hypomobility of the member: cerebral palsy, arthrogryposis and obstetrical brachial plexus palsy. These pathologies which differ on brain damage or not, have the same consequences due to the early achievement: negligence, stiffness and deformities. Regular entire clinical examination of the member, an assessment of needs in daily life, knowledge of the social and family environment, are key points for management. In these pathologies, the rehabilitation is an emergency, which began at birth and intensively...
October 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27676842/safety-and-effectiveness-of-early-intramuscular-botulinum-toxin-injections-to-prevent-shoulder-deformity-in-babies-with-obstetrical-brachial-plexus-palsy-presentation-of-a-multicentre-randomised-double-blind-placebo-controlled-trial
#7
Christelle Pons, Dinomais Mickael, Franck Fitoussi, Marie-Charlotte D'Anjou, Mélanie Porte, Emilie Rumilly, Nathaly Quintero, Philippe Violas, Sylvain Brochard
OBJECTIVE: In children with obstetrical brachial plexus palsy (OBPP), shoulder musculoskeletal deformity is the main cause of morbidity, with a loss of range of shoulder motion, pain and a reduction in social participation. Some uncontrolled studies show that early injections of botulinum toxin (BTI) in the internal shoulder rotator muscles (which cause the deformity) are one of the most promising treatments for the prevention of bony deformity. The main objective of this study will be the evaluation of the effectiveness of BTI in the internal shoulder rotator muscles at the age of 6 months in preventing an increase in posterior subluxation of the glenohumeral joint in babies with OBPP (evaluated at the ages of 5 and 12 months), compared with a placebo...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27648266/a-case-of-klumpke-s-obstetric-brachial-plexus-palsy-following-a-cesarean-section
#8
Mohammad M Al-Qattan, Amel A F El-Sayed
It is generally thought that Klumpke's palsy is not seen as obstetric injury. The authors present a case of Klumpke's palsy with Horner syndrome following delivery by emergency Cesarean section. Neurolysis and nerve grafting partially corrected the paralysis.
September 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27543083/distal-transfers-as-a-primary-treatment-in-obstetric-brachial-plexus-palsy-a-series-of-20-cases
#9
B A Ghanghurde, R Mehta, K M Ladkat, B B Raut, M R Thatte
UNLABELLED: The purpose of this study was to examine the results of spinal accessory nerve to suprascapular nerve (with or without axillary nerve neurotization) and an Oberlin transfer as primary treatment in children with Narakas type I obstetric brachial plexus injuries, when parents refused to consent to conventional nerve trunk-/root-level reconstruction. A total of 20 children with poor shoulder abduction and no biceps antigravity function but with good hand function were treated with spinal accessory nerve to suprascapular nerve and an Oberlin transfer at a mean age of 5...
October 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27402656/birth-brachial-plexus-palsy-a-race-against-time
#10
Sambeet Patra, Jayakrishnan K Narayana Kurup, Ashwath M Acharya, Anil K Bhat
A 5-year-old child presented to us with weakness of the left upper limb since birth. With the given history of obstetric trauma and limb examination, a diagnosis of birth brachial plexus palsy was made. Brachial plexus exploration along with microsurgery was performed at the same time which included extrinsic neurolysis of the roots and trunks and nerve transfer for better shoulder external rotation and elbow flexion. Both the movements were severely restricted previously due to co-contractures with the shoulder internal rotators and triceps...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27383724/nerve-transfer-for-elbow-extension-in-obstetrical-brachial-plexus-palsy
#11
Filippo M Senes, Nunzio Catena, Emanuela Dapelo, Jacopo Senes
No abstract text is available yet for this article.
May 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/27137902/clavicle-fracture-is-not-predictive-of-the-need-for-microsurgery-in-brachial-plexus-birth-palsy
#12
Holly B Leshikar, Andrea S Bauer, Nina Lightdale-Miric, Fred Molitor, Peter M Waters
BACKGROUND: Brachial plexus birth palsy (BPBP) and clavicle fractures occur concurrently as well as in isolation during difficult deliveries. The concept that concurrent clavicle fracture may spare nerve injury has been advocated. Our aim was to compare those children with BPBP presenting to a tertiary care center with and without concurrent clavicle fractures and assess the utility of the presence of a clavicle fracture as a predictor of injury severity in children with BPBP. METHODS: Records of all patients belonging to a large prospective multicenter cohort study of infants with BPBP (Treatment and Outcomes of Brachial Plexus Injuries study) were analyzed for demographic information and birth information including risk factors, comorbidity, presence of clavicle fracture, and injury severity...
April 30, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27094890/nerve-transfers-in-birth-related-brachial-plexus-injuries-where-do-we-stand
#13
REVIEW
Kristen M Davidge, Howard M Clarke, Gregory H Borschel
This article reviews the assessment and management of obstetrical brachial plexus palsy. The potential role of distal nerve transfers in the treatment of infants with Erb's palsy is discussed. Current evidence for motor outcomes after traditional reconstruction via interpositional nerve grafting and extraplexal nerve transfers is reviewed and compared with the recent literature on intraplexal distal nerve transfers in obstetrical brachial plexus injury.
May 2016: Hand Clinics
https://www.readbyqxmd.com/read/27058817/correction-of-elbow-flexion-contracture-by-means-of-olecranon-resection-and-anterior-arthrolysis-in-obstetrical-brachial-plexus-palsy-sequelae
#14
Filippo M Senes, Nunzio Catena, Emanuela Dapelo, Jacopo Senes
The authors have developed a particular surgical technique (olecranon bone resection together with anterior elbow arthrolysis) to increase the elbow's range of motion in adolescents and young adults suffering from elbow flexion contracture in obstetrical palsy sequelae. The surgical procedure was carried out in a preliminary group of 11 patients. The original procedure included a double incision: first of all by means of a posterior approach to resect the tip of the olecranon and then another incision carried out through the anteromedial aspect of the elbow, with a view to performing the anterior capsulotomy...
January 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/26961269/impaired-automatic-arm-movements-in-obstetric-brachial-plexus-palsy-suggest-a-central-disorder
#15
Galia V Anguelova, Martijn J A Malessy, Sonja M Buitenhuis, Erik W van Zwet, J Gert van Dijk
The authors aimed to find evidence for a central component of the impairment of movement of the affected arm in children with obstetric brachial plexus palsy. The authors performed a cross-sectional study in 19 children (median age 5 years) with obstetric brachial plexus palsy who were able to voluntarily abduct their affected arm beyond 90 degrees. They were asked to perform 4 tasks designed to provoke automatic arm movements to maintain balance. The authors assumed automatic motor programming to be impaired when 2 of 3 investigators agreed using video recordings that the affected arm did not abduct beyond 90 degrees while the unaffected arm did...
March 9, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/26959213/association-of-the-duration-of-active-pushing-with-obstetric-outcomes
#16
MULTICENTER STUDY
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To estimate the associations between the duration of active pushing during the second stage of labor and maternal and neonatal outcomes. METHODS: We performed an observational study in which data were obtained by trained abstractors from maternal and neonatal charts of deliveries at 25 hospitals over a 3-year period. In this secondary analysis, women with no prior cesarean delivery who had a term, singleton, cephalic gestation and reached complete dilation were analyzed...
April 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26902607/mrna-expression-characteristics-are-different-in-irreversibly-atrophic-intrinsic-muscles-of-the-forepaw-compared-with-reversibly-atrophic-biceps-in-a-rat-model-of-obstetric-brachial-plexus-palsy-obpp
#17
Ji-Xin Wu, Liang Chen, Fei Ding, Le-Zi Chen, Yu-Dong Gu
In obstetric brachial plexus palsy (OBPP), irreversible muscle atrophy occurs much faster in intrinsic muscles of the hand than in the biceps. To elucidate the mechanisms involved, mRNA expression profiles of denervated intrinsic muscles of the forepaw (IMF) and denervated biceps were determined by microarray using the rat model of OBPP where atrophy of IMF is irreversible while atrophy of biceps is reversible. Relative to contralateral control, 446 dysregulated mRNAs were detected in denervated IMF and mapped to 51 KEGG pathways, and 830 dysregulated mRNAs were detected in denervated biceps and mapped to 52 KEGG pathways...
April 2016: Journal of Muscle Research and Cell Motility
https://www.readbyqxmd.com/read/26806089/obstetrical-brachial-plexus-palsy-can-excision-of-upper-trunk-neuroma-and-nerve-grafting-improve-function-in-babies-with-adequate-elbow-flexion-at-nine-months-of-age
#18
Anne E Argenta, Jack Brooker, Zoe MacIssac, Megan Natali, Stephanie Greene, Meg Stanger, Lorelei Grunwaldt
Accepted indications for exploration in obstetrical brachial plexus palsy (OBPP) vary by center. Most agree that full elbow flexion against gravity at nine months of age implies high chance of spontaneous recovery and thus excludes a baby from surgical intervention. However, there are certain movements of the shoulder and forearm that may not be used frequently by the infant, but are extremely important functionally as they grow. These movements are difficult to assess in a baby and may lead to some clinicians to recommend conservative treatment, when this cohort of infants may in fact benefit substantially from surgery...
May 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/26762384/is-fetal-manipulation-during-shoulder-dystocia-management-associated-with-severe-maternal-and-neonatal-morbidities
#19
Bertrand Gachon, David Desseauve, Xavier Fritel, Fabrice Pierre
PURPOSE: There is a lack of data regarding maternal morbidity and neonatal hypoxia associated with shoulder dystocia (SD), particularly with respect to whether SD is managed with our without fetal manipulation (FM). Our main objective was to compare severe maternal and neonatal morbidities associated with SD according to FM execution. METHODS: We conducted a retrospective study based on a medical record analysis that included all SD cases from 2007 to 2012. SD was considered when additional maneuvers were required to complete a delivery...
September 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/26759018/oberlin-s-procedure-in-children-with-obstetric-brachial-plexus-palsy
#20
Roberta de Matos Figueiredo, Giuliana Grechi, Ricardo de Amoreira Gepp
PURPOSE: Most cases of obstetric brachial plexus palsy (OBPP) involve C5 and C6 nerve roots (Erb's palsy). In those cases, re-establishing the elbow flexion is the primary goal of surgery. The partial transfer of the ulnar nerve to the musculocutaneous nerve (Oberlin's procedure) is widely used in adults, but incipient in children. The purpose of this study is to describe the results obtained with such procedure as regards the improvement of the elbow flexion and donor nerve morbidity...
June 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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