Measuring secondary deformities of the shoulder in children with obstetric brachial plexus lesion: reliability of three methods

Sluijs, J.A. van der; Meij, M. van der; Verbeke, Jonathan; Manoliu, Radu A.; Wuisman, P.

doi:10.1097/01202412-200305000-00008

Cited by 3 publications

(8 citation statements)

References 16 publications

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“…Yet, future 3D studies with larger populations may want to investigate evaluating subsections of the glenoid or adding more categories (e.g., a flat glenoid) to provide further clinical insights. The 2D measures of concavity from both planes had similar reliability to past studies 16,17 but were below that of the current 3D measures.…”

Section: Three-dimensional Glenohumeral Deformities In Obppcontrasting

confidence: 46%

“…9,21,37,38 The relative percentage of convex glenoids in the current study was smaller than previously reported. 16 This difference likely arises from the fact that the current 3D measure is a quantitative measure derived from the entire glenoid surface, whereas previous 2D measures are qualitative and based on a single slice. Simplifying concavity into two 3D categories (concave vs. convex) allowed for a more direct comparison with past 2D studies.…”

Section: Three-dimensional Glenohumeral Deformities In Obppmentioning

confidence: 97%

“…1). The qualitative assessment of the glenoid concavity was based on a four item classification 16 : concave, convex, flat, or pseudo-glenoid.…”

Section: D Measuresmentioning

confidence: 99%

“…12 Posterior migration percentage (MP) and excessive glenoid retroversion of the involved shoulder, as measured in a single slice of an axial 3D magnetic resonance (MR) or computed tomography (CT) image set, has been extensively reported in the literature. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] These two-dimensional (2D) measures of glenoid shape have shown good intra-and inter-rater reliability in children with OBPP, 16,17 but their concurrent validity against 3D measures has not yet been assessed. Furthermore, the reported reliability is biased by all studies using a preselected imaging plane from a single image set, removing the variation in measurement caused by image plane location and orientation.…”

mentioning

confidence: 99%

“…Furthermore, the reported reliability is biased by all studies using a preselected imaging plane from a single image set, removing the variation in measurement caused by image plane location and orientation. 18,19 Concave, convex, and a "pseudo" glenoids have been reported in children with OBPP, 16 but the true concavity of a 3D surface is difficult to define based on a single slice through the surface. Standardization of image location and orientation are extremely difficult to achieve, especially in the case of deformity.…”

mentioning

confidence: 99%

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Three dimensionality of gleno‐humeral deformities in obstetrical brachial plexus palsy

Brochard

Mozingo

Alter

et al. 2015

Journal Orthopaedic Research

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The primary objective of this study was to test the hypothesis that gleno-humeral deformity in children and adolescent with obstetrical brachial plexus palsy is three-dimensional (3D). The study also compared the metrological properties of typical two-dimensional gleno-humeral measures to the newly developed 3D measures. Thirteen individuals (age = 11.8 ± 3.3 years) with obstetrical brachial plexus palsy participated in this IRB-approved study. 3D axial magnetic resonance images were acquired for both shoulders. Glenoid and humeral models were created in order to quantify 3D glenoid version, humeral head migration, and glenoid concavity. Two-dimensional (2D) measures were acquired as recommended in the literature. All measures were completed by two observers in this observer-blind study. Compared to the non-involved side, the glenoid was more retroverted (7.91°, p = 0.003) and inferiorly oriented (7.28°, p = 0.009). The humeral head was migrated more posteriorly (5.54 mm, p = 0.007), inferiorly (−3.96 mm, p = 0.013), and medially (−3.63 mm, p = 0.002). Eleven of the 13 glenoids were concave, based on the 3D glenoid models. The concurrent validity between three-and 2D measures were highly dependent of the parameter measured, the slice level used for the 2D analysis, and the presence/absence of pathology (0.63 3°) was larger than that for the 3D measure of version (<1°) on the involved side. This study clearly demonstrated that the gleno-humeral deformation in obstetrical brachial plexus palsy is 3D, emphasizing the need for 3D subject specific gleno-humeral shape analysis for follow-up and treatment plans in children with obstetrical brachial plexus palsy.

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Section: Three-dimensional Glenohumeral Deformities In Obppcontrasting

confidence: 46%

Section: Three-dimensional Glenohumeral Deformities In Obppmentioning

confidence: 97%

“…1). The qualitative assessment of the glenoid concavity was based on a four item classification 16 : concave, convex, flat, or pseudo-glenoid.…”

Section: D Measuresmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Three dimensionality of gleno‐humeral deformities in obstetrical brachial plexus palsy

Brochard

Mozingo

Alter

et al. 2015

Journal Orthopaedic Research

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Age Influence Upon Glenohumeral Remodeling After Shoulder Axial Rebalancing Surgery in Brachial Plexus Birth Injury

Hanneur

Brahim

Langlais

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Shoulder rebalancing procedures have been proven to provide satisfactory functional improvements in patients with shoulder external rotation (ER) deficit due to brachial plexus birth injury (BPBI). However, the influence of age at the time of surgery on osteoarticular remodeling remains uncertain. The purposes of this retrospective case series were (1) to assess the age impact on glenohumeral remodeling and (2) to determine an age limit after which significant changes can no longer be expected. Methods: We reviewed preoperative and postoperative magnetic resonance imaging data of 49 children with BPBI who underwent a tendon transfer to reanimate active shoulder ER, with (n=41) or without (n=8) concomitant anterior shoulder release to restore passive shoulder ER, at a mean age of 72 ± 40 months (19;172). Mean radiographic follow-up was 35 ± 20 months (12;95). Univariate linear regressions were used to assess the influence of age at the time of surgery upon changes of glenoid version, glenoid shape, percentage of the humeral head anterior to the glenoid midline, and glenohumeral deformity. Beta coefficients with 95% CI were calculated. Results: Improvements of glenoid version, glenoid shape, percentage of the humeral head anterior and glenohumeral deformity significantly decreased by 0.19 degrees [CI=(−0.31; −0.06), P=0.0046], 0.02 grade [CI=(−0.04; −0.01), P=0.002], 0.12% [CI=(−0.21; −0.04), P=0.0076], and 0.01 grade [CI=(−0.02; −0.01), P=0.0078] per additional month of age at the time of surgery, respectively. The threshold of 5 years was identified as the age at the time of surgery after which significant remodeling no longer occurred. No significant postoperative changes were observed in patients without glenohumeral dysplasia on preoperative magnetic resonance imaging. Conclusion: In the setting of BPBI-related glenohumeral dysplasia, the younger the surgical axial rebalancing of the shoulder, the greater the glenohumeral remodeling seems to be. Such procedure seems to be safe in patients without significant joint deformity on preoperative imaging. Level of Evidence: Therapeutic—Level IV.

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Arthroscopic Release of Subscapularis Tendon in Treatment of Adduction Internal Rotation Contracture of the Shoulder Joint Secondary to Obstetric Brachial Plexus Palsy

Ali

Sadek

El-Halawany

2023

Al-Azhar Medical Journal

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Background: Children with unresolved brachial plexus palsy frequently develop a disabling internal rotation contracture of the shoulder. Several surgical options, including soft tissue procedures such as muscle releases and/or transfers, and bone operations such as humeral osteotomy are available to correct this deformity.Objective: To evaluate the results obtained with arthroscopic release of subscapularis tendon in treatment of adduction internal rotation contracture of the shoulder joint secondary to obstetric brachial plexus paralysis. Patients and methods:This was a prospective study which had been conducted at Orthopedic Surgery Department, Al-Azhar University Hospitals (Al-Hussein and Sayed Galal Hospitals), the study included 10 patients with shoulder contracture secondary to obstetric brachial plexus palsy,from January 2020 to August 2021, Follow up, scheduled at immediately after operation, 2 weeks, 4 weeks, 2 months and 6 months post operatively. Result:The mean passive external rotation (ER) was 72.3° (40° -90°) and the mean active ER was 72.9° (20° -90°) at the end of follow up. The mean global Mallet score improved from 11.6 ± 1.07 SD (range from 10 to 13) preoperatively to 17.5 ± 2.22 SD (from 13 to 20) postoperatively. There were statistically significant differences between passive ER and Mallet score pre and post operatively. Passive ER, active ER and mallet score were higher among group with partial injury than complete injury but with no significant differences. There have been no intraoperative or postoperative complications. Conclusion:Isolated subscapularis tendon release was an easy, efficient and safe procedure in young children with shoulder adduction-internal rotation contracture due to obstetric brachial plexus palsy. It improved abduction and external rotation, but has no statistically significant influence on internal rotation.

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Measuring secondary deformities of the shoulder in children with obstetric brachial plexus lesion: reliability of three methods

Cited by 3 publications

References 16 publications

Three dimensionality of gleno‐humeral deformities in obstetrical brachial plexus palsy

Three dimensionality of gleno‐humeral deformities in obstetrical brachial plexus palsy

Age Influence Upon Glenohumeral Remodeling After Shoulder Axial Rebalancing Surgery in Brachial Plexus Birth Injury

Arthroscopic Release of Subscapularis Tendon in Treatment of Adduction Internal Rotation Contracture of the Shoulder Joint Secondary to Obstetric Brachial Plexus Palsy

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