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McDaid, Patrick J; Kozin, Scott H.; Thoder, Joseph J.; Porter, Scott

doi:10.1097/00004694-200205000-00019

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…The ratio of humeral length (involved/non-involved = 93.7%) was nearly identical to that reported previously (93% 28 ). This osseous atrophy is not limited to the head, but extended through the shaft to the elbow.…”

Section: Discussionsupporting

confidence: 88%

“…The documented humeral atrophy lends insights into the sequelae of OBPP and matched well with previous data 28 . The ratio of humeral length (involved/non-involved = 93.7%) was nearly identical to that reported previously (93% 28 ).…”

Section: Discussionsupporting

confidence: 84%

“…The studies that have focused on humeral pathology demonstrated atrophy 28; 37; 38 and “retroversion” on the involved side 46 . These studies were limited to 2D axial- or sagitall-plane analyses.…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional humeral morphologic alterations and atrophy associated with obstetrical brachial plexus palsy

Sheehan

Brochard

Behnam

et al. 2014

Journal of Shoulder and Elbow Surgery

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Background Obstetrical Brachial Plexus Palsy (OBPP) is a common birth injury, resulting in severe functional losses. Yet, little is known about how OBPP affects the 3D humeral morphology. Thus, the purpose of this study was to measure the 3D humeral architecture in children with unilateral OBPP. Methods Thirteen individuals (4F/9M, age=11.8±3.3 years, Mallet score=15.1±3.0) participated in this IRB-approved study. A three-dimensional T1-weighted gradient-recalled-echo magnet resonance image set was acquired for both upper limbs (involved/non-involved). Humeral size, version, and inclination were quantified from 3D humeral models derived from these images. Results The involved humeral head was significantly less retroverted and in declination (medial humeral head pointed anteriorly and inferiorly), relative to the non-involved side. Osseous atrophy was present in all three dimensions and affected the entire humerus. The inter-rater reliability was excellent (ICC = 0.96–1.00). Discussion This study demonstrated that both humeral atrophy and bone shape deformities associated with OBPP are not limited to the axial plane, but are three-dimensional phenomena. Incorporating information related to these multiplanar, 3D, humeral deformities into surgical planning could potentially improve functional outcomes following surgery. The documented reduction in retroversion is an osseous adaptation, which may help maintain glenohumeral congruency by partially compensating for the internal rotation of the arm. The humeral head declination is a novel finding and may be an important factor to consider when developing OBPP management strategies, as it has been shown to lead to significant supraspinatus inefficiencies and increased required elevation forces. Level of evidence Anatomic Study, Imaging

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

See 1 more Smart Citation

Three-dimensional humeral morphologic alterations and atrophy associated with obstetrical brachial plexus palsy

Sheehan

Brochard

Behnam

et al. 2014

Journal of Shoulder and Elbow Surgery

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“…With the incidence range of 0.5-5%, the perinatal brachial plexus palsy remains a concerning and challenging complication, despite the advances in obstetrics [10,12,13]. The majority of cases achieve a satisfactory recovery without surgical intervention [8,13] and, in particular, in cases of upper injuries of brachial plexus [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…McDaid et al analysed a group of 22 patients ranging from 4 to 16 years of age and concluded that discrepancies depend on lesion's location. In cases of total lesions, the shortening was greater in measurements of both whole limb length and forearm length, whilst in cases of upper brachial plexus lesions a subtler tendency to shortening of the forearm was observed [12]. …”

Section: Introductionmentioning

confidence: 99%

The effect of perinatal brachial plexus lesion on upper limb development

Gosk

Wnukiewicz

Urban

2014

BMC Musculoskelet Disord

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BackgroundDeficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development.MethodsForty-four patients with unilateral obstetric brachial plexus palsy underwent measurements of both upper extremities. The average age at the time of evaluation was 6.8 years. Active motion was assessed using Gilbert-Raimondi, the modified MRC, and Al-Qattan scales. Paired t test was used for statistical analysis. Correlation between limb length / circumference discrepancy and age / time of surgery was assessed using Pearson correlation coefficient.ResultsA decrease in the circumference and length was observed in all limbs with brachial plexus lesion. We found a statistically significant difference between degree of hand length and width decrease and its useful and useless function. We observed a statistically significant difference in measurement: forearm length, hand length and width dependent on the type of surgical procedure (neurolysis, reconstruction). We observed no correlation between age and limb length / circumference discrepancy. We also observed no correlation between time of surgery and limb length / circumference discrepancy.ConclusionsThe decrease in dimensions of the affected limbs occurred predominantly during the period of early childhood. Disparities in dimensions are observed in both cases of deficiency of useful function of upper limb and cases in which functional efficiency appears.

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