Glenohumeral Dysplasia Following Brachial Plexus Birth Injuries: A Review
Nathan Khabyeh-Hasbani1, Alexandra F Hoffman1, Erin Meisel2
1Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx , New York , USA.
Insights
Glenohumeral dysplasia (GHD) in children with brachial plexus birth injuries often progresses unnoticed. Early identification and multidisciplinary care are crucial for managing GHD and improving shoulder function.
Area of Science:
- Pediatric Orthopedics
- Neuroscience
- Developmental Biology
Background:
- Glenohumeral dysplasia (GHD) is a significant complication in children with brachial plexus birth injuries.
- GHD progression can occur even after initial treatment of the primary injury, leading to shoulder mobility issues.
- The condition arises from complex neural and muscular dysregulation affecting bone development.
Purpose of the Study:
- To review the current literature on the progression and management of GHD following brachial plexus birth injuries.
- To equip neurosurgeons with knowledge for identifying and treating GHD.
- To emphasize the importance of early GHD detection and intervention.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Scopus, Embase).
- Included articles focused on GHD progression, pathoanatomy, clinical presentation, and management.
- The review integrated findings from both neurosurgical and orthopedic literature.
Main Results:
- A multidisciplinary team approach is essential for managing brachial plexus birth injuries and preventing GHD.
- This team should include occupational therapists, neurosurgeons, plastic surgeons, and orthopedic surgeons.
- Collaborative care aims to correct the primary injury and mitigate GHD development.
Conclusions:
- Further research is needed to fully understand the complexities of GHD.
- Neurosurgeons require updated knowledge to effectively manage GHD in patients with brachial plexus birth injuries.
- Timely identification and treatment of GHD are critical for improving patient outcomes.
Background And Objectives:
Despite the high morbidity associated with glenohumeral dysplasia (GHD) in children with brachial plexus birth injuries, the progression of this condition often remains unnoticed, even after correcting for the underlying brachial plexus birth injuries. GHD, driven by a multifactorial process involving disruptions in both direct and indirect neural regulation of bony and muscular structures, can lead to intermittent or permanent shoulder mobility imbalances, significantly impacting the quality of life of those affected. Recent research efforts are increasingly directed toward identifying the root causes, managing the deformity, and determining effective treatment options for correcting GHD.
Methods:
A comprehensive search strategy was used by the authors to identify relevant literature relating to the progression, pathoanatomy, clinical presentation, and management of GHD following brachial plexus birth injuries across various search engines, such as PubMed, Scopus, and Embase. Considering the topic's interdisciplinary nature, articles were retrieved from both neurosurgical and orthopaedic journals to enrich the review.
Results:
Given the challenges in managing patients with brachial plexus birth injuries, a multidisciplinary care team consisting of certified occupational hand therapists, neurosurgeons, plastic surgeons, and orthopedic surgeons, specializing in brachial plexus injuries should be advocated for. The aim of this collaborative effort is to correct brachial plexus birth injuries and prevent the persistence of GHD.
Conclusion:
As research continues to focus on understanding the complexities of this condition, the aim of this review article is to summarize the current literature on the course of brachial plexus birth injury and the development of GHD. By doing so, we hope to provide neurosurgeons with the necessary knowledge and essential tools needed to identify and effectively treat GHD during management of brachial plexus birth injuries.
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