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Latissimus dorsi transfer for external rotation weakness of the shoulder in obstetric brachial plexus palsy

M M Al-Qattan1

  • 1Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia. moqattan@hotmail.com

Journal of Hand Surgery (Edinburgh, Scotland)
|September 5, 2003
PubMed

Insights

Latissimus dorsi transfer effectively improved shoulder external rotation in children with obstetric brachial plexus palsy. Most patients achieved significant active external rotation and functional improvement after surgery.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Pediatric Neurology

Background:

  • Obstetric brachial plexus palsy (OBPP) often results in shoulder external rotation weakness.
  • Functional limitations in OBPP can significantly impact a child's quality of life.
  • Surgical interventions are explored to restore shoulder function in affected children.

Purpose of the Study:

  • To evaluate the efficacy of latissimus dorsi transfer for shoulder external rotation weakness in children with OBPP.
  • To assess functional outcomes and range of motion following the surgical procedure.

Main Methods:

  • Latissimus dorsi transfer was performed in 12 children with OBPP meeting specific inclusion criteria.
  • Pre- and post-operative joint range of motion measurements were recorded.
  • A modified Mallet grading system was used for functional assessment of shoulder external rotation.

Main Results:

  • At a mean 4-year follow-up, 10 out of 12 children showed positive outcomes.
  • The 10 children achieved a mean active external rotation of 30 degrees (range, 20-60 degrees).
  • Mean shoulder abduction was 140 degrees (range, 90-170 degrees), and all achieved a modified Mallet score of 4.

Conclusions:

  • Latissimus dorsi transfer is a viable surgical option for improving shoulder external rotation in children with OBPP.
  • The procedure demonstrates significant functional gains and restoration of shoulder mobility.
  • Further monitoring is recommended due to a recurrence of deformity in two cases.

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