Outcome after later combined brachial plexus and shoulder surgery after birth trauma

Area of Science:

• Pediatric Orthopedics
• Neurosurgery
• Reconstructive Surgery

Background:

• Birth injuries to the brachial plexus can lead to significant upper extremity dysfunction.
• Sequelae of birth injuries often require complex surgical interventions.
• Combined upper brachial plexus and shoulder reconstruction addresses functional deficits in infants.

Purpose of the Study:

• To evaluate the outcomes of combined upper brachial plexus and shoulder reconstruction in infants with birth injury sequelae.
• To assess functional improvements using a standardized scale.
• To identify any persistent complications or need for secondary procedures.

Main Methods:

• A cohort of 22 infants (11-29 months) underwent combined upper brachial plexus and shoulder reconstruction.
• Nineteen patients were followed for a minimum of two years post-surgery.
• Outcomes were assessed using a modified Gilbert scale.

Main Results:

• All 19 followed patients demonstrated functional improvement, with an average gain of at least two grades on the modified Gilbert scale.
• Three patients required a secondary surgical procedure.
• Three patients experienced a persistent, minor internal rotation contracture.

Conclusions:

• Combined upper brachial plexus and shoulder reconstruction is an effective treatment for birth injury sequelae in infants.
• The procedure leads to significant functional gains, although secondary procedures may be necessary for some.
• Most patients experience substantial improvement in shoulder and upper extremity function.