Applying Transfer of Trapezius and/or Latissimus Dorsi with Teres Major for Reconstruction of Abduction and External Rotation of the Shoulder in Obstetrical Brachial Plexus Palsy

2002 ◽  
Vol 18 (4) ◽  
pp. 275-280 ◽  
Author(s):  
Liang Chen ◽  
Yu-dong Gu ◽  
Shao-nan Hu
Keyword(s):  
Brachial Plexus ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Brachial Plexus Palsy ◽  
Obstetrical Brachial Plexus Palsy ◽  
Teres Major

Latissimus Dorsi Transfer for External Rotation Weakness of the Shoulder in Obstetric Brachial Plexus Palsy

2003 ◽  
Vol 28 (5) ◽  
pp. 405-408 ◽  
Author(s):  
M. M. Al-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Skeletal Development ◽  
Shoulder Abduction ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Latissimus Dorsi Transfer ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation

This report describes the results of latissimus dorsi transfer for weakness of shoulder external rotation in 12 children with obstetric brachial plexus palsy. Selection criteria for the muscle transfer procedure included good passive external rotation of the shoulder, normal skeletal development of the shoulder joint, and adequate power of the deltoid. In addition to measuring the ranges of motion of joints before and after surgery, a modified Mallet grading system was utilized for the functional assessment of shoulder external rotation. At a mean follow-up of 4 years, two of the 12 children had recurrence of the shoulder deformity. In the remaining 10 children, the mean active external rotation was 30° (range, 20–60°), mean shoulder abduction was 140° (range, 90–170°), and all children had achieved a modified Mallet score of 4.

scholarly journals Extending the Indications for Primary Nerve Surgery in Obstetrical Brachial Plexus Palsy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Stuart A. Bade ◽  
Jenny C. Lin ◽  
Christine G. Curtis ◽  
Howard M. Clarke
Keyword(s):  
Brachial Plexus ◽  
Surgical Intervention ◽  
External Rotation ◽  
Shoulder Function ◽  
Small Subset ◽  
Brachial Plexus Palsy ◽  
Surgical Indications ◽  
Obstetrical Brachial Plexus Palsy ◽  
Spontaneous Improvement ◽  
Nerve Surgery

Purpose.This study identifies a small subset of patients with obstetrical brachial plexus palsy who, while they do not meet common surgical indications, may still benefit from primary nerve surgery.Methods.Between April 2004 and April 2009, 17 patients were offered primary nerve surgery despite not meeting the standard surgical indications of the authors. The authors performed a retrospective analysis of these 17 patients using prospectively collected data.Results.This group of 17 patients were identified as having poor shoulder function at about 9 months of age despite passing the Cookie Test. Fourteen patients underwent surgical intervention and three families declined surgery. All patients in the operative group regained some active external rotation after surgery. Five patients in this group have required further interventions. Two of the three patients for whom surgery was declined have had no subsequent spontaneous improvement in active external rotation.Discussion.The commonly used indications for primary nerve surgery in obstetrical brachial plexus palsy may not adequately identify all patients who may benefit from surgical intervention. Patients who pass the Cookie Test but have poor spontaneous recovery of active shoulder movements, particularly external rotation, may still benefit from primary nerve surgery.

scholarly journals Results of Sever- L’ Episcopo procedure for obstetric brachial plexus palsy

2016 ◽  
Vol 3 (1) ◽  
pp. 50
Author(s):  
Karthi Sundar V. ◽  
Anil Kumar S.V.
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Social Stigma ◽  
Functional Results ◽  
Functional Improvement ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Teres Major

<p class="abstract"><strong>Background:</strong> The reported incidence of obstetric brachial plexus palsy (OBPP) varies from 0.3 to 2.5 per 1000 live births<strong></strong>resulting in internal rotation deformity and weak abduction of the involved side shoulder<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> To retrospectively analyse the functional results of the Sever- L‘ Episcopo procedure for OBPP with a minimum follow-up of 2 years to a maximum of 13 years using modified Mallet scoring system for shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> A significant improvement in the range of abduction and the restoration of external rotation of shoulder was achieved with Sever- L’Episcopo procedure<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The results of secondary reconstruction of a dysfunctional shoulder by means of a Lattismus dorsi &amp; Teres major transfer as described by Sever- L’Episcopo is definitely beneficial. However this procedure will improve, but will not normalize, function. Apart from functional improvement this procedure corrects a deformity thereby easing the psycho-social stigma associated with it<span lang="EN-IN">.</span></p>

FUNCTIONAL RECONSTRUCTION OF THE IRREPARABLE UPPER TRUNK DEFECT OF THE BRACHIAL PLEXUS — A CASE REPORT

Hand Surgery ◽  
2004 ◽  
Vol 09 (01) ◽  
pp. 125-129 ◽  
Author(s):  
Liang Chen ◽  
Yu-dong Gu ◽  
Shao-nan Hu
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Elbow Flexion ◽  
Functional Reconstruction ◽  
Teres Major

We report a successful application of Oberlin's procedure combined with transfer of trapezius and latissimus dorsi with the teres major for reconstruction of elbow flexion as well as abduction and external rotation of the shoulder to a ten-year-old patient, who had a long defect of the left brachial plexus upper trunk caused by resection of the plexiform neuroma.

Tendon transfer for treatment of internal rotation contracture of the shoulder in brachial plexus birth palsy

2012 ◽  
Vol 37 (8) ◽  
pp. 781-786 ◽  
Author(s):  
H. Abdel-Ghani ◽  
K. A. Hamdy ◽  
N. Basha ◽  
Y. N. Tarraf
Keyword(s):  
Brachial Plexus ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Grading System ◽  
Latissimus Dorsi Transfer ◽  
Brachial Plexus Birth Palsy ◽  
Teres Major ◽  
Birth Palsy ◽  
Group B ◽  
Transfer Group

We retrospectively analyzed 63 patients with internal rotation contracture of the shoulder secondary to brachial plexus birth palsy treated with subscapularis sliding combined with either latissimus dorsi transfer (group A: n = 18) or latissimus dorsi and teres major transfer (group B: n = 45) to the rotator cuff. The mean age at time of surgery was 43 months (SD 21 months; range 8 months to 9 years). We used a modification of the Gilbert shoulder grading system for assessment. All patients showed statistically significant improvement of active shoulder abduction and external rotation without significant differences between the two groups. Significant external rotation contracture of the shoulder (inability to touch the abdomen with the wrist extended) occurred in 42 of 63 patients, and there was a greater incidence of external rotation contracture in group B. We conclude that surgery should be restricted to latissimus dorsi transfer without teres major transfer to avoid external rotation contractures. Our modification of the Gilbert grading system appears to be valid and applicable.

Sign in / Sign up

Export Citation Format

Share Document