title: Transfer of Pectoralis Major to Subscapularis in the Management of Brachial Plexus Birth Palsy Sequels.
abstract: BACKGROUND
  Limitations in abduction and external rotation are the sequel of brachial palsy. The purpose of this study was to evaluate functional outcomes of modified L'Episcopo procedure in children with brachial palsy who do not have gross shoulder joint subluxation.
  
  
  METHODS
  From 2002 to 2012, a continuous series of 22 patients with brachial plexus birth palsy underwent a modified L'Episcopo procedure. Through an axillary approach, subscapularis release with latissimus dorsi rerouting and transfer of pectoralis major to subscapularis footprint was performed.
  
  
  RESULTS
  The mean age of patients at surgery was 49 months. The mean follow-up time was 51 months (range, 24 to 90 mo). Preoperatively, the mean active abduction and external rotation were 77.5 and 2.5 degrees, respectively. The mean active abduction and external rotation were 135.6 and 32 degrees, respectively, at the final follow-up (P<0.001).
  
  
  CONCLUSIONS
  This modified L'Episcopo technique is an effective and reproducible procedure that improves shoulder function significantly.
  
  
  METHODS
  Level III.
authors.affiliation: *Shahid Beheshti University of Medical Sciences, Tehran †Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Faryvar A
authors.initials: FA
authors.lastname: Lahiji
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Tahririan
authors.forename: Mohsen
authors.initials: M
authors.lastname: Karami
authors.forename: Firooz
authors.initials: F
authors.lastname: Madadi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emami
authors.forename: Arash
authors.initials: A
authors.lastname: Maleki
mesh_terms: D001720:Birth Injuries / Q000150:complications*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010369:Pectoralis Muscles / Q000601:surgery* / Q000637:transplantation; D012399:Rotation; D017006:Rotator Cuff / Q000601:surgery*; D012785:Shoulder Joint; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome