Treatment results of shoulder medial rotation contractnre in older children with OBPP:comparison of rotation ostectomy and anterior release

Abstract

Objective To investigate the treatment outcomes of rotation osteetomy and anterior release for medial rotation contracture of the shoulder in obstetric brachial plexus palsy (OBPP) in older children.Methods Thirty-two eases of medial rotation contracture of the shoulder incurred as a sequela of OBPP who were treated between August 1999 and January 2007 were reviewed.Fifteen patients underwent anterior release of the eontracture soft tissues only.Seventeen patients had rotation osteotomy of the humerus and anterior release.Mallet score and Gilbert grading system were used to evaluate the function pre-and postoperatively.Results The patients were followed-up for 1 to 9 years.Mallet score of the patients who had anterior release and rotation osteotom7 (group A) increased from an average of 8.5 to 11.0.The average Mallet score of patients who had anterior release only ( group B) increased from 7.7 preoperatively to 8.7 postoperatively.Gilbert score of group A increased from grade 2.0 to grade 4.O,while Gilbert score of group B only changed from grade 2.0 to grade 2.8. ConclusionRotation ostectomy is the effective procedure for the medial rotation contracture of the shoulder in obstetric brachial plexus palsy in eider children. Key words: Paralysis,obstetric; Shoulder joint; Surgical procedures,operative; Rotaryosteotomy