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Brachial plexus obstetric

Orhan Beger, Uğur Dinç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
PURPOSE: The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. METHODS: Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 ± 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Eduardo de Almeida Guimarães Nogueira, Vitor Martinez de Carvalho, Marcos Vinicius de Queiroz, Gleysson Rodrigues Rosa, Yara Dadalti Fragoso
Augusta Marie Déjerine-Klumpke (1859-1927) was a formidable neurologist, neuroanatomist and researcher in France. One of the first women to be accepted for medical internship, externship and research in Paris, Augusta made her name studying and teaching anatomy, histology and dissection, attending clinical activities in neurology, obstetrics, pediatrics and neurologic trauma, performing necropsies, and writing scientific papers and book chapters. Her main research in neurology awarded her an eponym for the avulsion of the lowest root of the brachial plexus (Klumpke's palsy)...
February 2018: Arquivos de Neuro-psiquiatria
Alain Joe Azzi, Hassan AlNaeem, Camille Aubin-Lemay, Julie Chakriya Kvann, Peter Alam, Helene Retrouvey, Salah Aldekhayel, Teanoosh Zadeh
OBJECTIVE The purpose of this study was to compare shoulder abduction and external rotation (ER) after single-nerve repair of the upper trunk alone versus dual-nerve repair of both the upper trunk and the suprascapular nerve. METHODS A retrospective chart review of a single surgeon's experience repairing obstetrical brachial plexus injuries between June 1995 and June 2015 was performed. Eight patients underwent repair of the upper trunk alone, and 10 patients underwent repair of the upper trunk and the suprascapular nerve...
February 23, 2018: Journal of Neurosurgery. Pediatrics
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
Zeynep Hosbay, Safiye Ozkan, Muberra Tanriverdi, Atakan Aydin
STUDY DESIGN: Clinical measurement and cross-sectional study. INTRODUCTION: Numerous scales have been developed to examine activities of daily living and function in children with brachial plexus palsy. The Brachial Plexus Outcome Measure (BPOM) scale was developed in 2012 by Emily S. Ho and contains 14 items that measure activity and self-evaluation. PURPOSE OF THE STUDY: The aim of the study was to cross-culturally translate the BPOM scale into Turkish and test its measurement properties in children with brachial plexus palsy...
January 27, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Edith D Gurewitsch Allen
Mastery of shoulder dystocia management skills acquired via simulation training can reduce neonatal brachial plexus injury by 66% to 90%. However, the correlation between simulation drills and reduction in clinical injuries has been inconsistently replicated, and establishing a causal relationship between simulation training and reduction of adverse clinical events from shoulder dystocia is infeasible due to ethical limitations. Nevertheless, professional liability insurance carriers increasingly are mandating simulation-based rehearsal and competency assessment of their covered obstetric providers' shoulder dystocia management skills-a high-stakes demand that will require rapid scaling up of access to quality shoulder dystocia simulation...
January 29, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Ricardo Monreal
PURPOSE: The one-bone forearm arthrodesis has been performed to change the position of the forearm in children with fixed supination deformity due to upper extremity neurologic deficit. In this article, we present a retrospective review of children with late obstetric brachial plexus palsy who underwent palliative surgery to correct severe supination contracture by one-bone forearm osteodesis and biceps re-routing. This technique has not been described previously. MATERIALS AND METHODS: In this retrospective study, four consecutive patients with upper extremity weakness and severe supination contracture who underwent forearm osteodesis in neutral or slight pronation and biceps re-routing...
January 12, 2018: International Orthopaedics
Vaishali Upadhyaya, Divya Narain Upadhyaya, Brijesh Mishra
OBJECTIVES: Many studies have elaborated on the role of magnetic resonance neurography (MRN) in evaluating traumatic brachial plexopathies. Most of these deal with MR findings in adult traumatic plexopathies or children with obstetric brachial plexus palsy (OBPP). Hence, the authors felt the need for this particular study, which focuses on MRN findings in children with non-obstetric traumatic brachial plexus palsy, to find out the distribution and severity of injuries in these patients...
January 9, 2018: European Radiology
Jean-Sébastien Bourseul, Anais Molina, Mael Lintanf, Laetitia Houx, Emmanuelle Chaléat-Valayer, Christelle Pons, Sylvain Brochard
OBJECTIVE: To report current evidence regarding the safety of intramuscular BTI in children with orthopaedic- and neurological-related musculoskeletal disorders under the age of 2 years. DATA SOURCE: PUBMED, The Cochrane Library, and Science Direct, Google Scholar and Web of Science. STUDY SELECTION: Two reviewers independently selected studies based on predetermined inclusion criteria. DATA EXTRACTION: Data relating to the aim were extracted...
December 26, 2017: Archives of Physical Medicine and Rehabilitation
Vanessa Costil, Claudia Romana, Frank Fitoussi
PURPOSE: Obstetric brachial plexus palsy (OBPP) may result in a severe impairment of upper limb function, especially when major motor functions do not recover with or without early microsurgical reconstruction. Various methods to restore elbow flexion have been described. The aim of this study was to report the results after pectoralis minor transfer for elbow flexion restoration in late OBPP. METHODS: Nineteen patients were included. Mean age at surgery was six years (range, 2...
December 28, 2017: International Orthopaedics
Rahul K Nath, Sean G Boutros, Chandra Somasundaram
Background: Functional free gracilis muscle transfer is an operative procedure for elbow reconstruction in patients with complete brachial plexus nerve and avulsion injuries and in delayed or prolonged nerve denervation, as well as in patients with inadequate upper extremity function after primary nerve reconstruction. Methods: We retrospectively reviewed our patient records and identified 24 patients with complete brachial plexus nerve injury (13 obstetric, 11 males and 2 females; 11 traumatic, 9 males and 2 females) whose affected arm and shoulder were totally paralyzed and their voluntary elbow flexion or the biceps function was poor preoperatively (mean M0-1/5 in MRC grade)...
2017: Eplasty
S El-Shamy, R Alsharif
OBJECTIVES: The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury. METHODS: Forty children with Erb's palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks)...
December 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
Robert Bains, Abdullah Kattan, Christine G Curtis, Derek Stephens, Gregory Borschel, Howard M Clarke
PURPOSE: In our experience, and from the personal report of others, children with obstetrical brachial plexus palsy appear to lose some of their initially recovered active range of motion over the time in both operated and nonsurgical patients. This study investigates whether such a diminution of active movement occurs over time. METHODS: We performed a retrospective analysis of data from our obstetrical brachial plexus clinic. Between 1991 and 2000, 139 patients with a minimum follow-up of 10 years were included in the study...
November 21, 2017: Journal of Hand Surgery
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
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
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
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
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
Gráinne Bourke, Aleksandra M McGrath, Mikael Wiberg, Lev N Novikov
Obstetrical brachial plexus injury refers to injury observed at the time of delivery, which may lead to major functional impairment in the upper limb. In this study, the neuroprotective effect of early nerve repair following complete brachial plexus injury in neonatal rats was examined. Brachial plexus injury induced 90% loss of spinal motoneurons and 70% decrease in biceps muscle weight at 28 days after injury. Retrograde degeneration in spinal cord was associated with decreased density of dendritic branches and presynaptic boutons and increased density of astrocytes and macrophages/microglial cells...
January 1, 2017: Journal of Hand Surgery, European Volume
Flurina Michelotti, Christopher Flatley, Sailesh Kumar
BACKGROUND: Shoulder dystocia is an uncommon and unpredictable obstetric emergency. It is associated with significant neonatal, maternal and medico-legal consequences. AIM: To ascertain the impact shoulder dystocia has on severe neonatal and maternal outcomes specific to the type of manoeuvre. MATERIALS AND METHODS: This was a retrospective study of 48 021 term singleton vaginal deliveries the Mater Mothers' Hospital in Brisbane between 2007 and 2015...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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