Assessment of the Motor Power in Older Children with Obstetric Brachial Plexus Palsy

2003 ◽  
Vol 28 (1) ◽  
pp. 46-49 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Grading System ◽  
Motor Power ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
King Saud University ◽  
Grading Systems ◽  
Obstetric Brachial Plexus

The King Saud University (KSU) muscle grading system used for assessing the upper limb in older children with obstetric brachial plexus palsy is presented and compared to other muscle grading systems.

scholarly journals Obstetric Brachial Plexus Palsy: The Mallet Grading System for Shoulder Function—Revisited

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
M. M. Al-Qattan ◽  
A. A. F. El-Sayed
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Shoulder Function ◽  
Shoulder Abduction ◽  
Grading System ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation

The Mallet grading system is a commonly used functional scoring system to assess shoulder abduction/external rotation deficits in children with obstetric brachial plexus palsy. One feature of the Mallet score is that each grade is translated into certain degrees of deficiencies in both shoulder abduction and external rotation. The aim of the current study is to investigate the percentage of children in which the Mallet score could not be applied because of a discrepancy between the deficiency of shoulder abduction and shoulder external rotation. The study group included 50 consecutive unoperated older children (over 5 years of age) with Erb’s palsy and deficits in shoulder movements. The Mallet score could be applied in 40 cases (80%). In the remaining 10 cases (20%), the Mallet score could not be applied either because shoulder abduction had a better grade than the grade of shoulder external rotation (n=7) or vice versa (n=3). It was concluded that documenting the deficits in shoulder abduction and external rotation are best done separately and this can be accomplished by using other grading systems.

Obstetric Brachial Plexus Lesions: A Study of 74 Children Registered with the British Paediatric Surveillance Unit (March 1998–March 1999)

2003 ◽  
Vol 28 (1) ◽  
pp. 40-45 ◽  
Author(s):  
G. L. BISINELLA ◽  
R. BIRCH
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Surgical Correction ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Good Function ◽  
Secondary Deformity ◽  
Obstetric Brachial Plexus ◽  
Shoulder Deformity ◽  
Surveillance Unit

Seventy-four children with obstetric brachial plexus palsy registered with the British Paediatric Surveillance Unit were prospectively followed for a minimum of 2 years. Thirty-nine (52.7%) spontaneously recovered to normal or nearly normal levels and a further 29 (39.3%) regained good function in the upper limb. The most important secondary deformity involved the gleno-humeral joint and 20 patients (27%) needed surgical correction. Two more children await operation for shoulder deformity. The brachial plexus was explored in nine patients (12.2%) and repaired in seven.

Obstetric Brachial Plexus Palsy in Newborn Babies of Diabetic and Non-Diabetic Mothers

2010 ◽  
Vol 35 (5) ◽  
pp. 362-365 ◽  
Author(s):  
M.M. Al-Qattan ◽  
A.A.F. El-Sayed ◽  
A.Y. Al-Zahrani ◽  
S.A. Al-Mutairi ◽  
M.S. Al-Harbi ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Spontaneous Recovery ◽  
External Rotation ◽  
Elbow Flexion ◽  
Motor Power ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation ◽  
Diabetic Mothers

Compared to non-diabetic mothers, diabetic mothers are known to deliver larger babies who are at higher risk for shoulder dystocia and obstetric brachial plexus palsy. The intrapartum forces applied during delivery of larger babies are expected to be higher. Hence, the chances of these babies for good spontaneous recovery are expected to be lower; and this is a generally believed hypothesis. The objective of this retrospective study was to compare obstetric brachial plexus palsy in newborn babies of diabetic and non-diabetic mothers. There were a total of 655 cases of obstetric palsy: 253 cases with diabetic mothers and 402 with non-diabetic mothers. The former were more likely to develop total palsy while the latter were more likely to develop extended Erb’s palsy. Newborn babies of diabetic mothers had significantly larger birth weights than those of non-diabetic mothers regardless of the type of palsy. The rate of good spontaneous recovery of the motor power of the limb in the two groups was not significantly different except in total palsy cases for shoulder external rotation and elbow flexion where the recovery was significantly better in the diabetic group. It was concluded that the generally believed hypothesis is not correct if one compares the outcome in the diabetic and non-diabetic groups for each type of palsy.

Elbow Flexion Reconstruction by Steindler Flexorplasty in Obstetric Brachial Plexus Palsy

2005 ◽  
Vol 30 (4) ◽  
pp. 424-427 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Selection Criteria ◽  
Elbow Flexion ◽  
Drill Hole ◽  
Flexion Contracture ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

The results of Steindler flexorplasty in nine patients with obstetric brachial plexus palsy are reported. There were 5 girls and 4 boys with a mean age of 6 (range 2–13) years. Selection criteria for the procedure included strong (at least M4) grip strength and wrist and elbow extension, as well as the presence of the “Steindler effect”. Pre-operatively, elbow flexion was rated as M0 or M1 in three patients and M2 in the remaining six patients. Intra-operatively, the detached common flexor origin was advanced 5 to 7 cm and fixation was done to the anterior humerus either with direct suture to the periosteum (in younger children) or suturing into a drill hole in the humerus (in older children). Postoperatively, the elbow was immobilized in flexion and supination for 6 weeks. At a mean follow-up of 5 years, the results in eight patients were good with mean active elbow flexion against resistance of 110° and a mean elbow flexion contracture of 35°. The result in the remaining patient was poor (unsuccessful transfer). It is concluded that the results of the Steindler flexorplasty in obstetric brachial plexus palsy patients are good and reliable, provided patient selection is careful.

scholarly journals Treatment approach to shoulder internal rotation deformity in children with obstetric brachial plexus palsy

2018 ◽  
Vol 6 (2) ◽  
pp. 22-28 ◽  
Author(s):  
Olga E. Agranovich ◽  
Anatoly B. Oreshkov ◽  
Evgeniya F. Mikiashvili
Keyword(s):  
Brachial Plexus ◽  
Internal Rotation ◽  
Upper Limb ◽  
Glenohumeral Joint ◽  
Brachial Plexus Palsy ◽  
Limb Function ◽  
Obstetric Brachial Plexus Palsy ◽  
Tendon Transfers ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus

Introduction. Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with obstetric brachial plexus palsy because of the subsequent imbalance of the musculature and the abnormal deforming forces that cause dysplasia of the glenohumeral joint. Aim. To assess the effects of tendon transfers in children with shoulder internal rotation deformity due to obstetric brachial plexus palsy. Materials and methods. From 2015 to 2017, we examined and treated 15 patients with shoulder internal rotation deformity caused by obstetric brachial plexus palsy. The children ranged in age from 4 to 17 years. We used clinical and radiographic examination methods, including magnetic resonance imaging, electromyography, and electroneuromyography, of the upper limbs. Results. According to the level of plexus brachialis injury, the patients were divided into 3 groups: level С5–С6 (9 patients), level C5–C7 (5 children), level С5–Th1 (1 patient). All children had secondary shoulder deformities: glenohumeral dysplasia type II, 6 (40%); type III, 5 (34%); type IV, 1 (6%); and type V, 3 (20%). The Mallet score was used for estimation of upper limb function. Surgical treatment was performed in 15 children. After treatment, all patients showed improvement in activities of daily living. Conclusion. Tendon transfers in patients with shoulder internal rotation deformities due to obstetric brachial plexus palsy improved upper limb function and provided satisfactory cosmetic treatment results without of remodeling of the glenohumeral joint.

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