Motion Necessary to Achieve Mallet Internal Rotation Positions in Children With Brachial Plexus Birth Palsy

Russo, Stephanie A.; Kozin, Scott H.; Zlotolow, Dan A.; Nicholson, Kristen; Richards, James G.

doi:10.1097/bpo.0000000000001010

Cited by 17 publications

(21 citation statements)

References 31 publications

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“…In recent years, different surgical techniques including internal rotation osteotomy have been introduced to prevent loss of shoulder internal rotation (Abdel-Ghani et al., 2012; Sibinski et al., 2012). Although Russo et al. (2019) recommended evaluating shoulder internal rotation with hand to belly movement only prior to the surgery, the results of our study revealed that, due to the presence of postural internal rotation, shoulder internal rotation should be evaluated not only actively but also passively.…”

Section: Discussionmentioning

confidence: 77%

Relative importance of factors affecting activity and upper extremity function in children with Narakas Group 2 brachial plexus birth palsy

Delioğlu

Üzümcügil

Öztürk

et al. 2020

J Hand Surg Eur Vol

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The aim of the study was to determine the differences in upper limb function and activity/participation levels between preschool children with Narakas Groups 2a and 2b obstetric brachial plexus injury; and to determine the significance level of the factors affecting upper limb functions in these patients. Sixty-seven children, aged 3 to 7, who had not had surgical intervention, were evaluated in terms of joint movements, modified Mallet classification, Raimondi hand classification, brachial plexus outcome measure, paediatric outcome data collection instrument and stereognosis. There were significant functional differences between the groups, in favour of Group 2a. The movements affecting total function of the upper limb were: hand to spine ( p < 0.001), global abduction ( p < 0.001) and hand to mouth ( p < 0.001), in descending order of significance. Passive internal rotation was the most important passive joint movement affecting shoulder function ( p < 0.001). The results of this study suggest that more emphasis should be placed on the shoulder internal rotation in treatment strategies. Level of evidence: III

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Section: Discussionmentioning

confidence: 77%

Relative importance of factors affecting activity and upper extremity function in children with Narakas Group 2 brachial plexus birth palsy

Delioğlu

Üzümcügil

Öztürk

et al. 2020

J Hand Surg Eur Vol

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“…Visual grading based on the Active Movement Scale [ 10 ] and modified Mallet score [ 11 ] was developed to facilitate long-term follow-ups for range of motion and muscle function in BPBI patients and is used extensively throughout the world [ 5 ]. The scales are efficient and easy to implement in clinic but have been criticized as too subjective and missing crucial functional deficiencies [ 12 , 13 , 14 , 15 , 16 ]. Further, these scales do not describe how the glenohumeral joint and scapulothoracic articulation contribute to global shoulder (i.e., thoracohumeral) shoulder motion.…”

Section: Introductionmentioning

confidence: 99%

“…Goniometry and Medical Research Council 0–5 grading [ 20 ] are alternative methods to assess changes in range of motion and muscle strength but are difficult to implement in infants and younger children. Another approach is to use a three-dimensional kinematic analysis of the shoulder complex [ 12 , 21 , 22 , 23 ]. Such methods have been used to identify deficient external rotation in the glenohumeral joint and the global movement of the shoulder in children with BPBI when performing tasks of the modified Mallet scale [ 12 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Validity and Reliability of Wearable Motion Sensors for Clinical Assessment of Shoulder Function in Brachial Plexus Birth Injury

Grip

Källströmer

Öhberg

2022

Sensors

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The modified Mallet scale (MMS) is commonly used to grade shoulder function in brachial plexus birth injury (BPBI) but has limited sensitivity and cannot grade scapulothoracic and glenohumeral mobility. This study aims to evaluate if the addition of a wearable inertial movement unit (IMU) system could improve clinical assessment based on MMS. The system validity was analyzed with simultaneous measurements with the IMU system and an optical camera system in three asymptomatic individuals. Test–retest and interrater reliability were analyzed in nine asymptomatic individuals and six BPBI patients. IMUs were placed on the upper arm, forearm, scapula, and thorax. Peak angles, range of motion, and average joint angular speed in the shoulder, scapulothoracic, glenohumeral, and elbow joints were analyzed during mobility assessments and MMS tasks. In the validity tests, clusters of reflective markers were placed on the sensors. The validity was high with an error standard deviation below 3.6°. Intraclass correlation coefficients showed that 90.3% of the 69 outcome scores showed good-to-excellent test–retest reliability, and 41% of the scores gave significant differences between BPBI patients and controls with good-to-excellent test–retest reliability. The interrater reliability was moderate to excellent, implying that standardization is important if the patient is followed-up longitudinally.

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“…It is often challenging to achieve very wide arcs of shoulder rotation and elevation, but not many activities require two hands behind the back, far out to the sides or overhead. A roughly 90° arc of shoulder rotation that allows placement of the hand on the belly (at the extreme of internal rotation) 1 to just beyond neutral position (forearm forward at the extreme of external rotation) is arguably the most functionally useful range of movement in that axis. Achieving that range of active rotation allows for midline (dressing, buttoning, perineal care), bimanual and desktop function.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction for bone tumours of the shoulder and humerus in children and adolescents

Hopyan

2021

Journal of Children's Orthopaedics

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Reconstructions for paediatric bone tumours of the shoulder girdle and humerus are intended to optimize placement of the hand in space. Given the longevity of paediatric survivors of sarcoma, durability is an important planning consideration. Here, I review a subset of approaches based on anatomical site with an emphasis on function and longevity. Often, biological reconstructions that combine living bone with tendon repairs and transfers best address those goals.

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Motion Necessary to Achieve Mallet Internal Rotation Positions in Children With Brachial Plexus Birth Palsy

Abstract: Level II.

Cited by 17 publications

References 31 publications

Relative importance of factors affecting activity and upper extremity function in children with Narakas Group 2 brachial plexus birth palsy

Relative importance of factors affecting activity and upper extremity function in children with Narakas Group 2 brachial plexus birth palsy

Validity and Reliability of Wearable Motion Sensors for Clinical Assessment of Shoulder Function in Brachial Plexus Birth Injury

Reconstruction for bone tumours of the shoulder and humerus in children and adolescents

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