Related Experiment Videos
The shoulder in neonatal brachial palsy
1Orthopaedic Hospital, Los Angeles, CA 90007, USA.
Insights
Surgical interventions for neonatal brachial plexus injuries effectively restore shoulder function. Procedures like tendon transfers and fusions improved outcomes for affected children and adolescents.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Neurology
Background:
- Neonatal brachial plexus injuries commonly result in residual shoulder muscle weakness.
- External rotator weakness is a frequent challenge in managing these conditions.
Purpose of the Study:
- To evaluate the efficacy of various surgical procedures in addressing shoulder dysfunction secondary to neonatal brachial plexus injuries.
- To report functional outcomes and complications associated with these interventions.
Main Methods:
- Review of surgical cases involving neonatal brachial plexus injuries with shoulder involvement.
- Analysis of procedures including tendon transfers, closed reductions, glenohumeral fusions, and osteotomies.
- Assessment of functional improvements and postoperative complications.
Main Results:
- Over 84 tendon transfers were performed for external rotator weakness.
- Ten younger children underwent closed reduction, and nine adolescents received glenohumeral fusions.
- Four osteotomies and two open reductions were performed for shoulder dislocations in older adolescents.
Conclusions:
- Surgical management, including tendon transfers and fusions, leads to significant functional improvement in patients with neonatal brachial plexus injuries.
- These procedures are associated with a low rate of postoperative complications.
Abstract:
The most common residual weakness in neonatal brachial palsies involve the shoulder muscles. More than 84 tendon transfers were performed for weak external rotators. In addition to the tendon transfers, 10 younger children required closed reduction. Nine glenohumeral fusions were performed in adolescents. These procedures have resulted in improved function with few postoperative problems. Four osteotomies of the dislocated shoulder in older adolescents and two open reductions were performed in the older group of children.