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Glenohumeral deformity in children with brachial plexus birth injuries

David E Ruchelsman1, John A I Grossman, Andrew E Price

  • 1NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York, USA. druchelsman@partners.org

Bulletin of the NYU Hospital for Joint Diseases
|February 22, 2011
PubMed

Insights

Shoulder deformity is common after brachial plexus birth injuries. This study details management strategies for glenohumeral joint deformities, addressing both soft tissue and bony issues in affected children.

Area of Science:

  • Pediatric Orthopedics
  • Neonatal Neurology
  • Musculoskeletal Disorders

Background:

  • Shoulder deformity is the most frequent musculoskeletal complication of brachial plexus birth injuries.
  • Untreated glenohumeral deformity typically progresses, leading to significant morbidity in affected children.
  • Functional limitations arise from muscle denervation, soft tissue contractures, and progressive osseous deformities.

Purpose of the Study:

  • To present comprehensive, temporally-based management strategies for glenohumeral joint deformities in infants and children with brachial plexus birth injuries.
  • To address the challenges posed by glenohumeral dysplasia (GHD) and posterior shoulder dislocation.
  • To outline reconstructive procedures for soft tissues and bone.

Main Methods:

  • Review of management strategies for glenohumeral joint deformities.
  • Focus on temporally-based interventions.
  • Utilization of both soft tissue and bony reconstructive procedures.

Main Results:

  • Glenohumeral dysplasia (GHD) and posterior shoulder dislocation are prevalent in infants with brachial plexus birth injuries.
  • GHD encompasses a range of findings, including articular incongruities, dysplasia, subluxation, and dislocation.
  • Management strategies are designed to address progressive osseous deformities and functional limitations.

Conclusions:

  • Effective management of glenohumeral joint deformities in brachial plexus birth injuries requires a comprehensive, temporally-based approach.
  • Surgical reconstruction involving both soft tissue and bony procedures is crucial for improving function.
  • Early intervention and tailored strategies are key to mitigating long-term morbidity.

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