Abstract
Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with Obstetric Brachial Plexus Palsy. With progression of the deformity, the glenohumeral joint starts to subluxate and then dislocates. This is accompanied with bony changes of both the humerus and the glenoid. Two opposite direction humeral osteotomies have been proposed for this condition (internal rotation osteotomy (IRO) and external rotation osteotomy (ERO)). This fact of different direction osteotomies has not adequately been explained in the literature. Most orthopedic surgeons may not be able to fully differentiate between these two osteotomies regarding the indications, outcomes and effects on the joint. This review explains these differences in details.
Highlights
Obstetric brachial plexus palsy (OBPP) is an injury to the nerves of the upper extremity of the newborn that happens during labor
Some of them will have residual weakness of shoulder’s external rotation which will result in an internal rotation deformity of the affected shoulder in these children. If this internal rotation deformity is not repaired, it may progress to posterior dislocation of the shoulder joint with bony deformity of the glenoid [3]
The purpose of the surgery was to improve the cosmetic and the function of the upper extremity. This osteotomy would ignore the deformity in the glenohumeral joint as it will result in more posterior dislocation of the humeral head in relation to the glenoid
Summary
Obstetric brachial plexus palsy (OBPP) is an injury to the nerves of the upper extremity of the newborn that happens during labor. Some of them will have residual weakness of shoulder’s external rotation which will result in an internal rotation deformity of the affected shoulder in these children. If this internal rotation deformity is not repaired, it may progress to posterior dislocation of the shoulder joint with bony deformity of the glenoid [3]. The purpose of the surgery was to improve the cosmetic and the function of the upper extremity This osteotomy would ignore the deformity in the glenohumeral joint as it will result in more posterior dislocation of the humeral head in relation to the glenoid
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