title: Shoulder linked arthroplasty in patients with obstetric brachial plexus palsy can improve quality of life and function at short-term follow-up.
abstract: BACKGROUND
  Patients with obstetric brachial plexus palsy (OBPP) are prone to develop degenerative shoulder disease at a younger age than the general population. To date, no reports have been published on the complexities or outcome of shoulder arthroplasty (SA) in this unique patient group.
  
  
  METHODS
  We reviewed of 9 SAs in 9 patients (3 men and 6 women) with OBPP with mean follow-up 5.1 years (range, 2.6-7.6 years). Patients were a mean age of 29 years (range, 16-56 years). Patients had undergone a mean of 3 previous operations (range, 2-6). All patients underwent linked constrained SA.
  
  
  RESULTS
  The mean Oxford Shoulder Score increased from 8 (range, 3-10) preoperatively to 21 (range, 12-32) at the final follow-up (P < .001) predominantly due to pain relief. Mean range of active forward elevation and abduction improved from 35° and 39° to 46° and 45°, respectively. Patients improved significantly in 2 of 8 Short-Form 36-Item health-related quality of life domains, bodily pain (P = .013) and mental health (P = .035), and the overall physical component summary score (P = .006). Range of motion had mild improvements. Three required reoperation (33%), comprising 1 excision of heterotopic ossification, 1 trimming of a prominent screw, and 1 deltoid rupture repair.
  
  
  CONCLUSIONS
  SA is effective at relieving pain and health-related quality of life for young patients with OBPP; however, compared with the general population, the complication rate is high and functional gains are small.
authors.affiliation: Shoulder and Elbow Service, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
authors.forename: Will B J
authors.initials: WB
authors.lastname: Rudge
authors.affiliation: Shoulder and Elbow Service, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
authors.forename: Mathew David
authors.initials: MD
authors.lastname: Sewell
authors.affiliation: Shoulder and Elbow Service, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK. Electronic address: nawfal@yahoo.com.
authors.forename: Nawfal
authors.initials: N
authors.lastname: Al-Hadithy
authors.affiliation: Shoulder and Elbow Service, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
authors.forename: Charles N
authors.initials: CN
authors.lastname: Wallace
authors.affiliation: Shoulder and Elbow Service, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
authors.forename: Simon M
authors.initials: SM
authors.lastname: Lambert
mesh_terms: D000293:Adolescent; D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods*; D001720:Birth Injuries / Q000150:complications*; D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000209:etiology / Q000601:surgery*; D011788:Quality of Life; D020127:Recovery of Function; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Shoulder arthroplasty; obstetric brachial plexus palsy