Abstract
Background: Disabling internal rotation contractures are frequently experienced in children with unresolved birth brachial plexus palsies. Multiple surgical options like muscle release, tendon transfer, or humeral osteotomy are available to treat such cases. Purpose: Evaluation of the outcome of subscapularis release and latissimus dorsi and teres major tendon transfer in the management of obstetric brachial palsies in Mansoura University neurosurgical department. Study type: Retrospective observational study. Patients and Methods: Twenty-five cases who underwent subscapularis release and latissimus dorsi and teres major transfer were included in the study. All patients were subjected to complete history taking, through clinical examination. The degree of shoulder movement and disability was assessed via Modified Gilbert shoulder evaluation scale. Results: The least follow up period for our patients was 9 months. There was a clear improvement of shoulder function evaluated using Modified Gilbert shoulder evaluation scale as there were 73% of postoperative group between GIV and GV while about 84% of preoperative group were between GII and GIII. Conclusion: Tendon transfer is a valid easy procedure for correction of shoulder deformities in patients with obstetrical brachial plexus palsy. It is considered a very good option for patients who missed the chance of microsurgical repair or patients with poor shoulder recovery after surgery. Although some authors reported deterioration of shoulder function with log time follow up after tendon transfer, it is still better than those who were not operated.
Highlights
Disabling internal rotation contractures are frequently experienced in children with unresolved birth brachial plexus palsies
Patients and Methods: Twenty-five cases who underwent subscapularis release and latissimus dorsi and teres major transfer were included in the study
There was a clear improvement of shoulder function evaluated using Modified Gilbert shoulder evaluation scale as there were 73% of postoperative group between GIV and GV while about 84% of preoperative group were between GII and GIII
Summary
NBPP have been reported to affect 1.5 per 1000 live birth, and that ratio has not been decreased in recent days [2] The majority of these injuries are transient in nature and function will be restored completely in about 70% - 92% of cases, while in other cases, permanent disabling functional outcomes are reported [3]. Conclusion: Tendon transfer is a valid easy procedure for correction of shoulder deformities in patients with obstetrical brachial plexus palsy. It is considered a very good option for patients who missed the chance of microsurgical repair or patients with poor shoulder recovery after surgery. Some authors reported deterioration of shoulder function with log time follow up after tendon transfer, it is still better than those who were not operated
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