Team Approach: Management of Brachial Plexus Birth Injury

Schmieg, Sandra; Nguyen, Jie C.; Pehnke, Meagan; Yum, Sabrina W.; Shah, Apurva S.

doi:10.2106/jbjs.rvw.19.00200

Cited by 7 publications

(4 citation statements)

References 47 publications

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“…These can be assessed using follow‐up radiographs. In infants with Erb's palsy and history of shoulder dystocia, ultrasound is useful for mapping out injuries to the brachial plexus, associated muscle denervation injuries, and glenohumeral subluxation 12 . Ultrasound can be helpful intraoperatively to confirm glenohumeral reduction.…”

Section: Specification Of the Examinationmentioning

confidence: 99%

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination

2023

J of Ultrasound Medicine

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IntroductionT he American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices performing ultrasound examinations.The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination was revised by the American Institute of Ultrasound in Medicine (AIUM) in collaboration with other organizations whose members use ultrasound for performing this examination(s) (see "Acknowledgments"). Recommendations for personnel requirements, the request for the examination, documentation, quality assurance, and safety may vary among the organizations and may be addressed by each separately.This Practice Parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameters reflect what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the Parameter with recognition that deviations may occur depending on the clinical situation. IndicationsIndications for musculoskeletal ultrasound include, but are not limited to:1. Pain or dysfunction 2. Soft tissue or bone injury 3. Tendon, ligament, or fascial pathology 4. Arthritis, synovitis, or crystal deposition disease 5. Joint effusion and intraarticular bodies 6.

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Section: Specification Of the Examinationmentioning

confidence: 99%

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination

2023

J of Ultrasound Medicine

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“…Las variaciones en la tasa informada pueden atribuirse a diferencias geográficas en la privación socioeconómica, la atención obstétrica y el peso al nacer. 10…”

Section: Incidenciaunclassified

“…La utilización de estudios radiológicos o de electrodiagnóstico adicional es algo controvertida porque un buen examen físico proporciona la información necesaria para planear el manejo y ninguna de las modalidades puede predecir uniformemente el patrón exacto de lesión nerviosa. 8,10,20,21 Existen escalas de apoyo diagnóstico que nos ayudan a evaluar las lesiones. Una de las más completas y que en nuestro grupo utilizamos, es la escala de movimiento activo del Hospital para el Niño Enfermo de Toronto, 21,22 que evalúa el plexo braquial utilizando 15 movimientos diferentes de la extremidad superior, emplea una puntuación de 0 a 7 y evalúa cada movimiento sin gravedad y luego contra la gravedad, intentando pronosticar la recuperación neurológica con una puntuación compuesta.…”

Section: Diagnósticounclassified

Historia natural de la lesión de plexo braquial de nacimiento

Almejo¹,

Rocha²,

Portillo³

et al. 2020

Ortho-Tips

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“…More severe complications such as shoulder posterior subluxation and dislocation might also occur due to muscle imbalance [ 10 ]. Treatment of OBPI includes early rehabilitation in the first few months of life [ 11 ], and surgical treatment might be considered after 3 months of age based on the severity of function limitation [ 12 ]. Surgical intervention may include primary nerve surgery or secondary musculoskeletal surgery for situations caused by muscle imbalance or contracture [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Safety of Botulinum Neurotoxin in Obstetric Brachial Plexus Injury: A Systematic Review and Meta-Analysis

Chen

Lin

et al. 2022

Healthcare

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Obstetric brachial plexus injury, also known as neonatal brachial plexus injury, is not unusual in newborns. Given the lack of a comprehensive synthesis of the available data on the effectiveness of botulinum neurotoxin (BoNT) in treating children with obstetric brachial plexus injury, we conducted a systematic review and meta-analysis. We searched PubMed, Embase, Web of Science, and Cochrane databases from inception to 25 November 2022. Outcomes were function of the shoulder and elbow joints, muscle power of the deltoid, biceps brachii and triceps brachii, and the recurrence rate of subluxation or dislocation after reduction of the shoulder joint after BoNT application. Meta-regression was conducted to assess the moderator effect of age. We included 11 case series and 2 cohort studies. Passive range of motion of shoulder external rotation (standardized mean difference [SMD], 0.678; 95% confidence interval [95%CI], 0.423 to 0.934), Active Movement Scale for shoulder external rotation (SMD, 0.47; 95%CI, 0.131 to 0.808), and active range of motion of elbow extension (SMD, 2.445; 95%CI, 1.556 to 3.334) increased significantly after BoNT. However, the modified Gilbert scale for shoulder abduction (SMD, 1.239; 95% CI, −0.2 to 2.678), the Toronto score for active elbow flexion (SMD, 1.099; 95% CI, −0.053 to 2.252), muscle power of deltoid (SMD, 0.675; 95% CI, −0.599 to 1.949), biceps brachii (SMD, 0.225; 95% CI, −0.633 to 1.083), and triceps brachii (SMD, 1.354; 95% CI, −1.493 to 4.202) did not reach statistical significance. The moderator effect of age was not significant (p = 0.88). Meta-analysis was not done for recurrence rate of subluxation or dislocation due to insufficient data. In conclusion, our data support BoNT use in patients with obstetric brachial plexus injury. However, definite conclusions cannot be drawn due to small sample size and the lack of randomized controlled trials. More research is warranted to clarify the effectiveness of BoNT in patients with obstetric brachial plexus injury by using standardized injection protocols and outcome measurements.

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Team Approach: Management of Brachial Plexus Birth Injury

Cited by 7 publications

References 47 publications

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination

The AIUM Practice Parameter for the Performance of the Musculoskeletal Ultrasound Examination

Historia natural de la lesión de plexo braquial de nacimiento

The Effectiveness and Safety of Botulinum Neurotoxin in Obstetric Brachial Plexus Injury: A Systematic Review and Meta-Analysis

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