Related Experiment Video
Updated: Apr 4, 2026
Development of a Neonatal Rat Model for Brachial Plexus Birth Injury
Published on: March 27, 2026
Role of early shoulder tomography on the obstetric brachial plexus palsy
Bruno Liberato de Souza Silva1, Luiz Koiti Kimura1, Bruno Eiras Crepaldi1
1Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brazil, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Insights
Early shoulder tomography is crucial for infants with obstetric brachial plexus palsy (OBPP). This imaging helps identify severe shoulder dysplasia in children under 24 months, guiding more aggressive treatment and improving follow-up care.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Neurology
Background:
- Obstetric brachial plexus palsy (OBPP) can lead to significant shoulder dysplasia.
- Early detection of shoulder abnormalities is vital for effective management.
Purpose of the Study:
- To highlight the importance of early shoulder tomography in OBPP patients.
- To correlate physical examination findings with radiographic evidence of shoulder dysplasia.
Main Methods:
- Retrospective case series (Level of Evidence IV) of 76 OBPP patients.
- Patients divided into three age groups: ≤12 months, 13-24 months, and ≥25 months.
- Shoulder dysplasia assessed using the Waters scale via computed tomography and classified by Narakas.
Main Results:
- A statistically significant association (p=0.006) was found between age groups and Waters classification.
- Children under 24 months showed a strong correlation between physical findings and Waters > III (severe dysplasia).
- Older children (≥25 months) did not exhibit this strong correlation.
Conclusions:
- A correlation exists between physical exam findings and severe shoulder dysplasia in children under 24 months with OBPP.
- Early tomographic shoulder examination is justified for better follow-up and considering aggressive treatment.
- This supports timely imaging for optimal management of OBPP.
Objective:
To demonstrate the importance of performing early shoulder tomography in patients with obstetric brachial plexus palsy (OBPP).
Methods:
This series of cases retrospective study with level evidence IV was conducted by consulting 76 patient's medical records with OBPP divided into three age groups: ≤12 months, 13 to 24 months and ≥ 25 months. The patients were classified according to gender, affected side, type of paralysis according to Narakas classification, and by computed tomography, according to the Waters scale.
Results:
The association between the age groups with Waters classification was statistically significant (p=0,006), showing that patients in the group aged less than 12 months and in the group aged between 12 and 24 months had a relevant correlation between the physical examination and Waters > III when compared to patients from groups aged 25 months or older.
Conclusion:
This study shows a correlation between the findings in the physical examination and severe dysplasia on the shoulder of children under 24 months of age, justifying the early tomographic shoulder exam in order to achieve a better follow-up and a consider a more aggressive approach in the treatment of OBPP affected children. Level of Evidence IV, Case Series.
More Related Videos
06:51Methods for In Vivo Biomechanical Testing on Brachial Plexus in Neonatal Piglets
Published on: December 19, 2019
09:14Surface Electromyographic Biofeedback as a Rehabilitation Tool for Patients with Global Brachial Plexus Injury Receiving Bionic Reconstruction
Published on: September 28, 2019
Related Concept Videos
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:22Spinal Nerves: Plexus I
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation