Abstract
BackgroundDeficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development.MethodsForty-four patients with unilateral obstetric brachial plexus palsy underwent measurements of both upper extremities. The average age at the time of evaluation was 6.8 years. Active motion was assessed using Gilbert-Raimondi, the modified MRC, and Al-Qattan scales. Paired t test was used for statistical analysis. Correlation between limb length / circumference discrepancy and age / time of surgery was assessed using Pearson correlation coefficient.ResultsA decrease in the circumference and length was observed in all limbs with brachial plexus lesion. We found a statistically significant difference between degree of hand length and width decrease and its useful and useless function. We observed a statistically significant difference in measurement: forearm length, hand length and width dependent on the type of surgical procedure (neurolysis, reconstruction). We observed no correlation between age and limb length / circumference discrepancy. We also observed no correlation between time of surgery and limb length / circumference discrepancy.ConclusionsThe decrease in dimensions of the affected limbs occurred predominantly during the period of early childhood. Disparities in dimensions are observed in both cases of deficiency of useful function of upper limb and cases in which functional efficiency appears.
Highlights
Deficiency in upper limb development is a sequel of the perinatal brachial plexus palsy
Differences in upper limb length between healthy and affected limbs are more pronounced in total brachial plexus lesions than upper lesions [11]
In cases of total lesions, the shortening was greater in measurements of both whole limb length and forearm length, whilst in cases of upper brachial plexus lesions a subtler tendency to shortening of the forearm was observed [12]
Summary
Deficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development. The most common consequences of obstetric brachial plexus lesion include the neurological symptoms [1,2,3,4,5,6,7,8,9] and deficiency in upper limb development [10,11,12,13]. In cases of total lesions, the shortening was greater in measurements of both whole limb length and forearm length, whilst in cases of upper brachial plexus lesions a subtler tendency to shortening of the forearm was observed [12]. The occurrence of disorders of upper limb development in the course of perinatal brachial plexus palsy is a
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