Subscapularis Z-plasty With Coracoidectomy for Internal Rotation Contracture in Children With Brachial Plexus Birth...

Area of Science:

• Orthopedic Surgery
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Brachial plexus birth injury (BPBI) is a complication of dystocia with variable functional outcomes.
• Existing data on shoulder function improvement and complication rates after BPBI interventions are conflicting.
• Standardized outcome measures are needed to evaluate surgical interventions for BPBI.

Purpose of the Study:

• To evaluate the effectiveness of subscapularis z-lengthening with coracoidectomy for brachial plexus birth injury.
• To assess improvements in shoulder function, including Mallet scores and passive external rotation (PER).
• To report surgical outcomes and complication rates in BPBI patients.

Main Methods:

• Retrospective study at King Faisal Specialist Hospital and Research Center.
• Data collected included patient demographics, Mallet scores, and passive external rotation (PER) in adduction and abduction.
• Analysis of outcomes following subscapularis z-lengthening and coracoidectomy.

Main Results:

• Significant improvement in active shoulder function and Mallet scores (P=0.00).
• Most notable gains in active external rotation and hand-to-neck movements.
• Sustained improvement in PER in adduction and abduction at a mean follow-up of 2.9 years.

Conclusions:

• Subscapularis z-lengthening with coracoidectomy is effective for correcting internal rotation contractures in BPBI.
• The procedure leads to significant improvements in Mallet scores and passive external rotation.
• This surgical approach offers a consistent and effective solution for managing shoulder dysfunction in BPBI.