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The Pericoracoid Tissue Release in Children With Brachial Plexus Birth Injury

Akin Uzumcugil1, Kıvanç Delioğlu2, Abdurrahman Yilmaz1

  • 1Department of Orthopedics and Traumatology, Hacettepe University, Ankara, Turkey.

The Journal of Hand Surgery
|November 12, 2024
PubMed

Insights

Pericoracoid tissue release surgery improved shoulder movement in children with brachial plexus birth injury (BPBI). This intervention, combined with physiotherapy, reduced multidirectional deficits, enhancing upper-extremity function.

Area of Science:

  • Pediatric Orthopedics
  • Pediatric Surgery
  • Rehabilitation Medicine

Background:

  • Brachial plexus birth injury (BPBI) often results in multidirectional shoulder movement deficits.
  • Children with upper trunk BPBI experience limitations in abduction, hand-to-neck, hand-to-abdomen, and hand-to-spine movements.

Purpose of the Study:

  • To evaluate pericoracoid tissue release and structured physiotherapy as a primary treatment for reducing movement deficits in BPBI.
  • To assess the efficacy of this surgical approach in improving shoulder function.

Main Methods:

  • Thirty-four children with BPBI underwent pericoracoid tissue release (ligament release, pectoralis minor release, coracoid osteotomy).
  • Patients received 1 year of follow-up physiotherapy and a home exercise program.
  • Upper-extremity function, passive joint movements, and acromion-to-table distance were measured pre- and post-surgery.

Main Results:

  • Significant improvements were observed in all modified Mallet classification tasks.
  • Active Movement Scale showed increased shoulder flexion, abduction, and rotation.
  • Passive range of motion improved in abduction and rotation; decreased acromion-to-table distance indicated improved symmetry.

Conclusions:

  • Pericoracoid tissue release is an effective first-step intervention for BPBI.
  • The procedure, coupled with physiotherapy, leads to multidirectional improvements in shoulder joint mobility.
  • This approach successfully reduces movement deficits in children with BPBI.
Abstract

Keywords:
Anterior approachbrachial plexuspericoraciod releaseshouldersurgery

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