title: Extended long-term (5 years) outcomes of triangle tilt surgery in obstetric brachial plexus injury.
abstract: OBJECTIVE
  We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008.
  
  
  METHODS
  Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale.
  
  
  RESULTS
  Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5±0.6 to 4.1±0.8, p<0.0001), hand-to-spine (2.6±0.6 to 3.4±1.1, p<0.005), hand-to-neck (2.7±0.7 to 4.3±0.7, p<0.0001), hand-to-mouth (2.3±0.9 (92º±33) to 4.2±0.5 (21º±16), p<0.0001), and supination (2.6±1.1 (-8.2º ±51) to 4.1±0.7 (61±32)) were significantly improved (p<0.0001), and maintained over the extended long-term (5 years). Total modified Mallet functional score was also shown to improve from 14.1±2.7 to 20.3±2.5.
  
  
  CONCLUSIONS
  The triangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients.
authors.affiliation: Texas Nerve and Paralysis Institute, 6400 Fannin Street, Houston, Texas, 77030, USA.
authors.forename: Rahul K
authors.initials: RK
authors.lastname: Nath
authors.forename: Chandra
authors.initials: C
authors.lastname: Somasundaram
keywords: Obstetric brachial plexus injury; extended long-term; modified Mallet score; triangle tilt surgery; upper extremity function.