Elbow flexion after primary reconstruction in obstetric brachial plexus palsy.
Fifty-two children (54 upper extremities) with obstetric brachial plexus palsy who underwent primary reconstruction for elbow flexion restoration were studied. The outcomes were analysed in relation to the type of brachial plexus lesion, timing of surgery, and the type of reconstruction. Overall, 42 of 54 extremities (78%) achieved good and excellent results (> or =M3+). The average postoperative muscle grading for the biceps was 3.7 (SD 0.8), and the average postoperative active elbow flexion was 108 degrees (SD 33 degrees ). The average elbow flexion contracture was 18 degrees (SD 21 degrees ). The timing of surgery and the type of the brachial plexus injury significantly influenced the final outcome. The best results were seen in early cases (< or =3 months), where the lateral cord was reconstructed from intraplexus donors. In this group, minimal flexion contracture deformity was observed. Late reconstruction (> or =7 months) of the musculocutaneous nerve resulted in inferior results.
Terzis
J K
JK
Department of Surgery, Division of Plastic and Reconstructive Surgery, Microsurgery Program, Eastern Virginia Medical School, Norfolk, Virginia 23501, USA. mrc@jkterzis.com
Kokkalis
Z T
ZT
D000293:Adolescent; D000367:Age Factors; D001720:Birth Injuries / Q000503:physiopathology / Q000601:surgery*; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004550:Elbow / Q000294:innervation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D009138:Musculocutaneous Nerve / Q000601:surgery; D016067:Nerve Transfer / Q000379:methods*; D010525:Peripheral Nerves / Q000503:physiopathology / Q000637:transplantation*; D011183:Postoperative Complications / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology*; D012086:Reoperation; D055815:Young Adult