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Narakas brachial

Omar A Al-Mohrej, Nehal A Mahabbat, Asad F Khesheaim, Nezar B Hamdi
BACKGROUND: Obstetric brachial plexus palsy (OBPP) is considered a rare, unpredictable, and unavoidable injury of the upper limb. In this study, we presented a retrospective cohort study over a period of ten years in King Faisal Specialists Hospital and Research Centre (KFSH&RC), Riyadh, Saudi Arabia, to assess the characteristics and functional outcomes of OBPP. METHODS: Between January 2005 and December 2015, we carried out 125 repairs of OBPP in KFSH&RC...
May 18, 2018: International Orthopaedics
Lesley Butler, Janith Mills, Heather M Richard, Russell Riddle, Marybeth Ezaki, Scott Oishi
PURPOSE: The prevalence of neonatal brachial plexus palsy (NBPP) has been increasing since the early 1980s. No known studies have examined long-term psychological health and quality of life (QOL) in young adults. The purpose of this study was to investigate the psychosocial and intellectual aspects of NBPP during adolescence into young adulthood. METHODS: A total of 31 patients were enrolled in the adolescent group (16 to 18 y) and 25 in the young adult group (23 to 28 y)...
September 2017: Journal of Pediatric Orthopedics
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
Thomas J Wilson, Kate W C Chang, Lynda J S Yang
BACKGROUND: Neonatal brachial plexus palsy (NBPP) results in reduced function of the affected arm with profound ramifications on quality of life. Advances in surgical technique have shown improvements in outcomes for appropriately selected patients. Patient selection, however, remains difficult. OBJECTIVE: To develop a decision algorithm that could be applied at the individual patient level, early in life, to reliably predict persistent NBPP that would benefit from surgery...
March 1, 2018: Neurosurgery
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...
March 2017: Physiological Measurement
Christopher J Coroneos, Sophocles H Voineskos, Marie K Christakis, Achilleas Thoma, James R Bain, Melissa C Brouwers
OBJECTIVE: The objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of expertise. SETTING: The guideline is intended for all healthcare providers treating infants and children, and all specialists treating upper extremity injuries...
January 27, 2017: BMJ Open
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
G Leblebicioglu, C Ayhan, T Firat, A Uzumcugil, M Yorubulut, M N Doral
UNLABELLED: Transfer of the contralateral C7 nerve for reconstruction of the brachial plexus in infants with obstetrical brachial plexus injury has rarely been reported. We developed a new endoscopy-assisted technique via the prevertebral (retroesophageal) route for the transfer of the contralateral C7 nerve in reconstruction of the brachial plexus. The reconstruction was performed in 20 infants (14 boys and six girls). Motor recovery was assessed using the Gilbert and Raimondi scales...
October 2016: Journal of Hand Surgery, European Volume
Scott L Zuckerman, Laura A Allen, Camille Broome, Nadine Bradley, Charlie Law, Chevis Shannon, John C Wellons
PURPOSE: This study aimed to investigate the functional outcomes of infants who underwent neurotization for shoulder abduction and elbow flexion in Narakas grade 1 birth-related brachial plexus palsy (BRBPP) and compare this cohort to children who progressed past the point of needing intervention. METHODS: A cohort study was conducted at a single center between 1999 and 2010. Two-hundred and eight infants were identified with BRBPP that presented for neurosurgical care as infants...
May 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Thomas J Wilson, Kate W C Chang, Suneet P Chauhan, Lynda J S Yang
OBJECTIVE Neonatal brachial plexus palsy (NBPP) occurs due to the stretching of the nerves of the brachial plexus before, during, or after delivery. NBPP can resolve spontaneously or become persistent. To determine if nerve surgery is indicated, predicting recovery is necessary but difficult. Historical attempts explored the association of recovery with only clinical and electrodiagnostic examinations. However, no data exist regarding the neonatal and peripartum factors associated with NBPP persistence. METHODS This retrospective cohort study involved all NBPP patients at the University of Michigan between 2005 and 2015...
May 2016: Journal of Neurosurgery. Pediatrics
Matthew L Iorio, Sarah J Menashe, Ramesh S Iyer, Sarah P Lewis, Suzanne Steinman, Kathryn B Whitlock, Raymond W Tse
PURPOSE: To evaluate the presence and degree of glenohumeral dysplasia (GHD) in infants undergoing surgical exploration for neonatal brachial plexus palsy (NBPP) and to identify potential predictive factors of early maladaptive shoulder morphology. METHODS: We included all consecutive patients with NBPP who underwent surgical exploration of their brachial plexus and who had a preoperative magnetic resonance imaging scan at our institution over a 3-year period. Demographic, therapy, and surgical data were collected...
December 2015: Journal of Hand Surgery
Bruno Liberato de Souza Silva, Luiz Koiti Kimura, Bruno Eiras Crepaldi, Rames Mattar, Álvaro Baik Cho, Rubén Montiel Oviedo
OBJECTIVE: To demonstrate the importance of performing early shoulder tomography in patients with obstetric brachial plexus palsy (OBPP). METHODS: This series of cases retrospective study with level evidence IV was conducted by consulting 76 patient's medical records with OBPP divided into three age groups: ≤12 months, 13 to 24 months and ≥ 25 months. The patients were classified according to gender, affected side, type of paralysis according to Narakas classification, and by computed tomography, according to the Waters scale...
January 2015: Acta Ortopedica Brasileira
Avreeta K Singh, Janith Mills, Andrea S Bauer, Marybeth Ezaki
Fetal macrosomia is associated with a 14-fold increased risk of brachial plexus birth palsy (BPBP), and is a predictor of childhood obesity. The purpose of this study was to identify the relationships between BPBP, fetal macrosomia, and childhood obesity. We retrospectively reviewed 214 children with BPBP. The average age was 8 years and 53% had a Narakas 1 grade BPBP. Overall, 49% of children were normal weight, 22% overweight, and 29% obese. Of the children with a history of fetal macrosomia, 41% were obese; a statistically significant difference...
November 2015: Journal of Pediatric Orthopedics. Part B
Denise Justice, Lynnette Rasmussen, Michael Di Pietro, Kate W-C Chang, Susan L Murphy, Virginia S Nelson, Lynda J-S Yang
BACKGROUND: Children with neonatal brachial plexus palsy (NBPP) are often prescribed shoulder range of motion (ROM) exercises; however, the extent and timing of exercise implementation remains controversial in the context of shoulder joint integrity. The association of ROM exercises to delayed posterior shoulder subluxation (PSS) is unknown. OBJECTIVE: To determine prevalence of PSS in children with NBPP who began full passive ROM exercises before 6 months of age, and characteristics associated with development or absence of PSS in children...
December 2015: PM & R: the Journal of Injury, Function, and Rehabilitation
F H M Souza, S N Bernardino, H C Azevedo Filho, P L Gobbato, R S Martins, H A L Martins, R P Silva-Néto
OBJECTIVE: To evaluate the transfer of the spinal accessory nerve to the suprascapular nerve through the anterior or posterior approach in patients with late traumatic brachial plexus injuries. METHODS: This study includes patients with late brachial plexus injuries that underwent a spinal accessory-to-suprascapular nerve transfer. They were divided into two equal groups, A and B, in which the spinal accessory nerve was transferred to the suprascapular nerve, respectively, through the anterior or posterior approach...
December 2014: Acta Neurochirurgica
Kate Wan-Chu Chang, Lynda J-S Yang, Lynn Driver, Virginia S Nelson
AIM: An association of language impairment with neonatal brachial plexus palsy has not been reported in the literature. The current treatment paradigm for neonatal brachial plexus palsy focuses on upper extremity motor recovery with little formal assessment of other aspects of development, such as language. We performed a cross-sectional pilot study to investigate early language delay prevalence in toddlers with neonatal brachial plexus palsy and potential neonatal brachial plexus palsy-related factors involved...
September 2014: Pediatric Neurology
Lynnette Rasmussen, Denise Justice, Kate W-C Chang, Virginia S Nelson, Lynda J-S Yang
OBJECTIVE: To evaluate the accuracy of home exercise performance by caregivers of children with neonatal brachial plexus palsy (NBPP) who use digital versatile disc (DVD) guidance. DESIGN: Prospective cohort study. SETTING: Brachial Plexus Clinic at the University of Michigan. PARTICIPANTS: Seventy-six adult caregivers of a consecutive cohort of pediatric patients with NBPP. METHODS: Caregivers received the Home Exercise Program for Brachial Plexus Palsy DVD and an initial demonstration of correct hand placement and movement patterns by 1 of 2 occupational therapists...
November 2013: PM & R: the Journal of Injury, Function, and Rehabilitation
Johanna M Ruoff, Johannes A van der Sluijs, Willem J van Ouwerkerk, Richard T Jaspers
AIM: Denervation after obstetric brachial plexus lesion (OBPL) is associated with reduced musculoskeletal growth in the upper arm. The aim of this study was to investigate whether reduced growth of upper arm flexor and extensor muscles is related to active elbow function and humeral length. METHOD: In this study, 31 infants age less than 6 months (mean age 4.3mo; range 2.1-5.9mo; 17 males; 14 females;) with unilateral OBPL (Narakas class I, 19; II, 3; III, 2; and IV, 7) treated at the VU medical centre, in whom neurosurgical reconstruction was considered were prospectively studied using magnetic resonance imaging of both arms at a mean age of 4...
November 2012: Developmental Medicine and Child Neurology
Shawn L Hervey-Jumper, Denise Justice, Monique M Vanaman, Virginia S Nelson, Lynda J-S Yang
We investigate the incidence of torticollis associated with neonatal brachial plexus palsy, whether the severity of brachial plexus palsy affects outcomes and the rate of recovery. We performed a retrospective review of 128 consecutive neonatal brachial plexus palsy patients evaluated at the University of Michigan from 2005-2009. Patients were followed for at least 3 months, with regular physical examinations and imaging. Forty-three percent presented concurrently with torticollis. Significant differences were evident in mean age at first brachial plexus examination, suggesting that patients with concurrent torticollis present earlier for clinical examination...
November 2011: Pediatric Neurology
Kiymet Ikbal Karadavut, Sukran Ozden Uneri
OBJECTIVE: To evaluate depression, anxiety and burnout in mothers of infants with brachial plexus injury and assess the effects of the severity of injury on the mothers' mental health, as the literature provides no information on this topic. STUDY DESIGN: The study was based on eighteen mothers without psychiatric antecedents who had infants with perinatal brachial plexus paralysis (PBPP). The severity of the brachial plexus injury was classified according to the Narakas classification system...
July 2011: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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