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Obstetrical brachial plexus palsy

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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
#1
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
#2
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
#3
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...
July 27, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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/postoperative-physical-therapy-program-for-latissimus-dorsi-and-teres-major-tendons-transfer-to-rotator-cuff-in-children-with-obstetrical-brachial-plexus-injury
#17
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
https://www.readbyqxmd.com/read/27784179/neonatal-brachial-plexus-palsy-obstetric-factors-associated-with-litigation
#18
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...
October 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27763629/risk-factors-for-persistent-disability-in-children-with-obstetric-brachial-plexus-palsy
#19
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
#20
REVIEW
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
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