Incidence of early posterior shoulder dislocation in brachial plexus birth palsy

Area of Science:

• Pediatric Orthopedics
• Neonatal Neurology
• Musculoskeletal Disorders

Background:

• Posterior shoulder dislocation is a rare complication in infants diagnosed with brachial plexus birth palsy.
• While uncommon in the first year, its incidence rises with age.
• This study focuses on determining the occurrence of these dislocations in infants under one year old.

Purpose of the Study:

• To calculate the incidence of posterior shoulder dislocation in infants under one year of age with brachial plexus birth palsy.
• To establish the prevalence of this specific complication within the first year of life.

Main Methods:

• A prospective follow-up study was conducted on all brachial plexus patients under one year of age in Malmö municipality, Sweden, between 2000 and 2005.
• Data collection included incidence rates of brachial plexus birth lesions and the occurrence of posterior shoulder dislocation.
• Diagnosis of posterior shoulder dislocation was confirmed through history, clinical examination, and X-ray.

Main Results:

• The incidence of brachial plexus birth palsy was found to be 3.8 per 1000 live births annually.
• The incidence of posterior shoulder dislocation in the first year of life was 0.28 per 1000 live births annually.
• Posterior shoulder dislocation was identified in 7.3% of all brachial plexus birth palsy cases.

Conclusions:

• All infants diagnosed with brachial plexus birth palsy (3.8 per 1000) require screening for posterior shoulder dislocation during their first year.
• Early detection of posterior shoulder dislocation (0.28 per 1000) is crucial, irrespective of neurological recovery assessment.
• Approximately 7% of infants with brachial plexus birth palsy may develop posterior shoulder dislocation, necessitating vigilant monitoring.