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Limb length differences after obstetrical brachial plexus injury: a growing concern

James R Bain1, Carol DeMatteo, Deborah Gjertsen

  • 1Hamilton, Ontario, Canada From the Division of Plastic Surgery, Department of Surgery, the School of Rehabilitation Science, and the CanChild Centre for Childhood Disability Research, McMaster University, and McMaster Children's Hospital.

Plastic and Reconstructive Surgery
|September 29, 2012
PubMed

Insights

Obstetrical brachial plexus injury causes significant arm and forearm length differences in children. Early limb length deficits predict the need for surgical reconstruction.

Area of Science:

  • Pediatric Orthopedics
  • Neurology
  • Developmental Pediatrics

Background:

  • Obstetrical brachial plexus injury (OBPI) can lead to limb size discrepancies, a poorly understood complication.
  • This study investigates limb length differences in children with OBPI compared to typically developing peers.

Purpose of the Study:

  • To quantify limb length differences in children with OBPI.
  • To explore the influence of age, growth, injury severity, and surgery on these differences.
  • To assess the reliability of clinical limb length measurement techniques.

Main Methods:

  • A prospective cohort of 179 children with OBPI underwent systematic limb length and girth measurements.
  • Measurements were taken at regular intervals up to 12 months, then annually.
  • A control group of typically developing children had single limb measurements.

Main Results:

  • Clinical limb length measurement techniques showed high interrater reliability (ICC=0.90).
  • Significant arm, forearm, and total limb length differences were observed as early as 1 month post-injury.
  • Early limb length deficits at 3 months predicted 12-month differences.

Conclusions:

  • OBPI significantly impacts arm and forearm length.
  • Early detection of limb length deficits can indicate potential need for surgical intervention.
  • Clinical limb length measurement is a reliable and noninvasive assessment tool.
Abstract

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