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Shoulder deformities from obstetrical brachial plexus paralysis
1Department of Radiology of the Rehabilitation Centre for Children, Winnipeg, Canada.
Insights
Children with chronic birth injury brachial plexus paralysis often develop shoulder abnormalities. These include underdeveloped humeral heads, abnormal clavicles, and elevated scapulae, with some experiencing shoulder subluxation.
Area of Science:
- Pediatric Orthopedics
- Neuromuscular Disorders
- Skeletal Dysplasias
Background:
- Birth injuries can lead to chronic brachial plexus paralysis in children.
- Brachial plexus injuries can significantly impact upper extremity development and function.
- Shoulder abnormalities are a potential long-term complication of pediatric brachial plexus palsy.
Purpose of the Study:
- To describe the specific shoulder abnormalities in pediatric patients with chronic brachial plexus paralysis from birth injuries.
- To document the spectrum of skeletal malformations affecting the shoulder girdle in this patient population.
Main Methods:
- Retrospective review of 11 pediatric patients (up to 17 years) with chronic brachial plexus paralysis due to birth injuries.
- Clinical and radiographic assessment of shoulder structures, including the humeral head, clavicle, scapula, and glenoid fossa.
Main Results:
- Common abnormalities included hypoplastic and poorly formed humeral heads.
- Patients exhibited short, abnormally formed clavicles and hypoplastic, elevated scapulae.
- Specific scapular findings included shallow glenoid fossae, inferiorly directed coracoid processes, and tapered acromions.
- Four patients presented with associated shoulder subluxation.
Conclusions:
- Chronic brachial plexus paralysis from birth injuries is associated with significant and varied shoulder girdle abnormalities in pediatric patients.
- These skeletal abnormalities can affect multiple components of the shoulder joint, potentially contributing to functional deficits.
- Early recognition and management of these shoulder malformations are crucial for optimizing outcomes in affected children.
Abstract:
Abnormalities are described in the shoulders of 11 patients up to 17 years of age who have chronic brachial plexus paralyses from birth injuries. These abnormalities include a poorly formed and hypoplastic humeral head, a short abnormally formed clavicle, and a hypoplastic elevated scapula with a shallow glenoid fossa, inferiorly directed coracoid process, and abnormally tapered acromion. Four also had subluxated shoulders.