Muscle transfers in children and adults improve external rotation in cases of obstetrical brachial plexus paralysis: a comparative study

Purpose Latissimus dorsi and teres major transfers to the lateral side of the humerus with lengthening of the pectoralis major and subscapularis muscles for residual shoulder deformity were compared in children and skeletally mature patients. Methods Fifteen patients (nine children, six skeletally m...

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Bibliographic Details
Published in:International orthopaedics 2014-04, Vol.38 (4), p.803-810
Main Authors: Chomiak, Jiří, Dungl, Pavel, Ošťádal, Martin, Frydrychová, Monika, Burian, Michal
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brachial Plexus Neuropathies - physiopathology
Brachial Plexus Neuropathies - surgery
Child
Child, Preschool
Humans
Medicine
Medicine & Public Health
Muscle, Skeletal - transplantation
Original Paper
Orthopedics
Range of Motion, Articular
Rotation
Treatment Outcome
Young Adult
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Summary:Purpose Latissimus dorsi and teres major transfers to the lateral side of the humerus with lengthening of the pectoralis major and subscapularis muscles for residual shoulder deformity were compared in children and skeletally mature patients. Methods Fifteen patients (nine children, six skeletally mature patients aged three to 30 years, follow-up one to 22 years) were treated for internal shoulder contracture after birth plexus lesions: C5–C6 (seven patients); C5–7 (five patients); C5-C8-T1 (three patients, respectively). Range of movement, Mallet shoulder function score and radiographs were assessed. Results Pre-operatively, shoulder function restrictions were comparable in all patients. Postoperatively, external rotation, abduction and Mallet function score improved significantly ( p <  0.05) in all patients except one. There were no differences in improvement between children and skeletally mature patients ( p =  0.24–1.0). Conclusions This technique improves external rotation and abduction of the shoulder for daily living activities in children and young, skeletally mature, patients.
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-013-2202-0