title: Muscle transfers in children and adults improve external rotation in cases of obstetrical brachial plexus paralysis: a comparative study.
abstract: OBJECTIVE
  Latissimus dorsi and teres major transfers to the lateral side of the humerus with lengthening of the pectoralis major and subscapularis muscles for residual shoulder deformity were compared in children and skeletally mature patients.
  
  
  METHODS
  Fifteen patients (nine children, six skeletally mature patients aged three to 30 years, follow-up one to 22 years) were treated for internal shoulder contracture after birth plexus lesions: C5-C6 (seven patients); C5-7 (five patients); C5-C8-T1 (three patients, respectively). Range of movement, Mallet shoulder function score and radiographs were assessed.
  
  
  RESULTS
  Pre-operatively, shoulder function restrictions were comparable in all patients. Postoperatively, external rotation, abduction and Mallet function score improved significantly (p < 0.05) in all patients except one. There were no differences in improvement between children and skeletally mature patients (p = 0.24-1.0).
  
  
  CONCLUSIONS
  This technique improves external rotation and abduction of the shoulder for daily living activities in children and young, skeletally mature, patients.
authors: Department of Orthopaedics, 1st Faculty of Medicine Charles University and Hospital Na Bulovce, Budínova 2, 18081, Prague 8, Czech Republic, chomiakjiri@yahoo.com.
authors: Jiří
authors: J
authors: Chomiak
authors: Pavel
authors: P
authors: Dungl
authors: Martin
authors: M
authors: Ošťádal
authors: Monika
authors: M
authors: Frydrychová
authors: Michal
authors: M
authors: Burian
mesh_terms: D000293:Adolescent; D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D018482:Muscle, Skeletal / Q000637:transplantation*; D016059:Range of Motion, Articular; D012399:Rotation; D016896:Treatment Outcome; D055815:Young Adult