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Brachial plexus obstetric

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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/28711374/the-components-of-shoulder-and-elbow-movements-as-goals-of-primary-reconstructive-operation-in-obstetric-brachial-plexus-lesions
#5
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...
June 30, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28709767/obstetrical-brachial-plexus-palsy
#6
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 11, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28674717/obstetric-brachial-plexus-injury-knowledge-among-health-care-providers-in-saudi-arabia
#7
Rakan S Al-Essa, Rakan M Al-Khilaiwi, Ali A Al-Qahtani, Abdullah M Al-Thunayan, Mohammad M Al-Qattan
To assess the basic knowledge on obstetric brachial plexus injury among obstetricians, pediatricians, and physio-/occupational therapists in major hospitals in Riyadh.  We aimed to identify if inadequate knowledge is the reason behind delayed referrals to the Hand Clinic. Methods: This is a cross-sectional questionnaire-based study  conducted at 5 major hospitals in Riyadh, Saudi Arabia between June 2015 and August 2015.  A questionnaire of 6 questions (multiple choice closed-ended questions) was given to obstetricians, pediatricians, and  physio-/occupational therapists' in these selected hospitals...
July 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28650063/-obstetric-brachial-plexus-palsy-incidence-monitoring-of-progress-and-prognostic-factors
#8
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/28627963/the-natural-history-of-recovery-of-elbow-flexion-after-obstetric-brachial-plexus-injury-managed-without-nerve-repair
#9
T E J Hems, T Savaridas, D A Sherlock
In this study, we report the outcome for spontaneous recovery of elbow flexion in obstetric brachial plexus injury managed without nerve reconstruction. Excluding those with transient paralysis, our records revealed 152 children with obstetric brachial plexus injury born before our unit routinely offered brachial plexus reconstruction. Five had had nerve repairs. Of the remainder, only one patient had insufficient flexion to reach their mouth. Elbow flexion started to recover clinically at a mean age of 4 months for Narakas Group 1, 6 months for Group 2, 8 months for Group 3 and 12 months for Group 4...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28609352/comparing-the-efficacy-of-triple-nerve-transfers-with-nerve-graft-reconstruction-in-upper-trunk-obstetrical-brachial-plexus-injury
#10
Kathleen M O'Grady, Hollie A Power, Jaret L Olson, Michael J Morhart, A Robertson Harrop, M Joe Watt, K Ming Chan
BACKGROUND: Upper trunk obstetrical brachial plexus injury (OBPI) can cause profound shoulder and elbow dysfunction. Although neuroma excision with interpositional sural nerve grafting is the current gold standard, distal nerve transfers have a number of potential advantages. The goal of this study was to compare the clinical outcomes and healthcare costs between nerve grafting and distal nerve transfers in children with upper trunk OBPI. METHODS: In this prospective cohort study, children who received triple nerve transfers were followed with the Active Movement Scale (AMS) for 2 years...
June 12, 2017: Plastic and Reconstructive Surgery
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 slowly improved over the last 45 years. Changes in strategy, techniques, microsurgical equipment and technology have expanded the surgical options to reconstruct these life altering, highly complex injuries. The surgical armamentarium includes neurolysis, nerve repair, nerve grafting, nerve transfers, tendon transfer, muscle transfer and other soft tissue and bony procedures. In this article we have selected five surgical procedures (Oberlin's procedure, Leechavengvongs' procedure, free functional muscle transfer, radial nerve tendon transfers and C5-C6 nerve grafting in obstetrical birth palsy) that have consistently given us good results in our patients who require surgical reconstruction...
May 31, 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/28445364/n-acetylcysteine-prevents-retrograde-motor-neuron-death-after-neonatal-peripheral-nerve-injury
#16
Joseph Catapano, Jennifer Zhang, David Scholl, Cameron Chiang, Tessa Gordon, Gregory H Borschel
BACKGROUND: Neuronal death may be an overlooked and unaddressed component of disability following neonatal nerve injuries, such as obstetric brachial plexus injury. N-acetylcysteine and acetyl-L-carnitine improve survival of neurons after adult nerve injury, but it is unknown whether they improve survival after neonatal injury, when neurons are most susceptible to retrograde neuronal death. The authors' objective was to examine whether N-acetylcysteine or acetyl-L-carnitine treatment improves survival of neonatal motor or sensory neurons in a rat model of neonatal nerve injury...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28442854/biceps-rerouting-after-forearm-osteotomy-an-effective-treatment-strategy-for-severe-supination-deformity-in-obstetric-plexus-palsy
#17
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/28412107/glenoid-morphology-in-obstetrical-brachial-plexus-lesion-a-three-dimensional-computed-tomography-study
#18
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
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
#19
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
#20
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...
January 15, 2017: Clinical Biomechanics
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