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Shoulder deformities in obstetric brachial plexus paralysis: a computed tomography study.
Julia K Terzis1, Marios D Vekris, Seiichiro Okajima
1Department of Surgery, Division of Plastic and Reconstructive Surgery, Eastern Virginia Medical School, Norfolk, Virginia 23501, USA. mrc1@erols.com
Journal of Pediatric Orthopedics
|February 27, 2003
Summary
Obstetric brachial plexus palsy can cause shoulder deformities. Computed tomographic (CT) scanning reveals that surgical reconstruction improves shoulder joint congruency and function, decreasing deformities.
Area of Science:
- Orthopedic surgery
- Pediatric neurology
- Radiology
Background:
- Obstetric brachial plexus palsy (OBPP) often affects upper limb nerve roots, leading to shoulder deformities if untreated.
- Characteristic shoulder deformities are common sequelae of untreated OBPP, impacting shoulder kinetics.
Purpose of the Study:
- To objectively investigate shoulder deformities in OBPP using computed tomographic (CT) scanning.
- To evaluate the effectiveness of surgical reconstruction (nerve repairs and secondary procedures) on shoulder deformities and function in OBPP patients.
Main Methods:
- Specific measurements were taken from CT scans of bilateral upper limbs in OBPP patients.
- Measurements were performed before and after surgical reconstruction procedures.
Main Results:
- Surgical restoration of external rotation and scapula stabilization corrected humeral head inclination.
- Procedures significantly improved shoulder joint congruency and decreased scapular winging.
- CT measurements documented improvements in shoulder kinetics post-intervention.
Conclusions:
- CT scanning provides an objective method to assess shoulder changes in OBPP over time.
- Microsurgical interventions demonstrate measurable benefits in improving shoulder joint mechanics and function in OBPP.
- Periodic CT evaluation is valuable for monitoring OBPP evolution and surgical outcomes.