External Rotation Predicts Outcomes After Closed Glenohumeral Joint Reduction With Botulinum Toxin Type A in Brachial Plexus Birth Palsy

Abstract

Level IV-therapeutic.

The Use of Botulinum Toxin Injection for Brachial Plexus Birth Injuries: A Systematic Review of the Literature

“…The BTX-A was injected into the pectoralis muscle and often times in combination with the latissimus dorsi muscle. 2,4-6,9,13,14,16…”

“…Eight articles were identified describing the indication for BTX-A on internal rotation/adduction contracture of the glenohumeral joint. 2,[4][5][6]9,13,14,16 A total of 220 patients were treated with BTX-A within these 8 articles. The BTX-A was injected into the pectoralis muscle and often times in combination with the latissimus dorsi muscle.…”

“…The BTX-A was injected into the pectoralis muscle and often times in combination with the latissimus dorsi muscle. 2,[4][5][6]9,13,14,16 Shin et al performed a prospective case report of 4 patients whose shoulder abduction function was not improved by occupational therapy/physical therapy(OT/ PT) alone. BTX-A was injected intramuscularly into the pectoralis major muscle and functional improvement monitored 1 and 6 months post injection.…”

“…Age was not found to be a predictor of outcomes. 9 Duijnisveld et al performed a prospective comparative study with a 5-year follow-up including 15 patients with internal rotation contracture treated with BTX-A injected into the subscapularis muscle. The passive external rotation increased 10 degrees after 3 months and no significant changes were seen after 1 or 5 years.…”

“…Five articles were identified that utilized BTX-A for the treatment of biceps/triceps co-contractures. 2,4,10,13,15 A total of 60 patients with biceps/triceps co-contracture were 4 Case series Level IV Desiato and Risina, 2001 5 Prospective cohort Level III Price et al, 2007 14 Retrospective cohort Level IV Rollnik et al, 2000 15 Retrospective cohort Level IV Duijnisveld et al, 2017 6 Prospective comparative Level III Greenhill et al, 2018 9 Retrospective cohort Level IV Michaud et al, 2014 13 Retrospective cohort Level IV Shin et al, 2014 16 Case report Level V Hierner et al, 2001 11 Retrospective cohort Level IV…”