The Results of Surgical Treatment of the Forearm Deformity in Perinatal Brachial Plexus Palsy

• Authors: Jerzy Gosk , Roman Rutowski , Maciej Urban , Roman Wiącek , Witold Wnukiewicz , Piotr Mazurek
• Languages of publication: EN

Abstracts

EN

The aim of the study was the estimation of the results of surgical correction in pronation or supination forearm deformity.Material and methods. Clinical material comprised 19 patients, both sexes, in age from 2 years 3 months to 14 years who were treated in years 2001-2007 because of forearm deformation due to perinatal brachial plexus palsy. Evaluation of the results of surgical treatment has been performed in all cases with using Al-Qattan's scale.Results. As a result of performed tenomioplastic operations in all operated patients functional position of forearm has been achieved (grade 3 in Al-Qattan's scale)., and in 8 cases additionally good range of pronation and supination (grade 4 in Al-Qattan's scale).Conclusions. The necessity of forearm deformity correction in perinatal brachial plexus palsy may concern patients who have been treated microsurgically in very early childhood, and also patients who haven't been qualified to primary surgical treatment because of significant improvement of upper limb function as a result of rehabilitation. Tenomioplastic operations used in forearm position correction should be reserved for patients without fixed contracture who have possibility of forearm passive rotation moves. These procedures are burdened by low risk of complications and with proper qualification they can provide significant improvement of upper limb functional efficiency.

Keywords

EN

supination forearm deformity; pronation forearm deformity; perinatal brachial plexus palsy; surgical treatment

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2010
• Volume: 82
• Issue: 11
• Pages: 610-614

Dates

published

1 - 11 - 2010

online

7 - 1 - 2011

Contributors

author

Jerzy Gosk

• Department of Traumatology, Clinic of Traumatology and Hand Surgery, Medical University in Wrocław

author

Roman Rutowski

author

Maciej Urban

• Department of Traumatology, Clinic of Traumatology and Hand Surgery, Medical University in Wrocław

author

Roman Wiącek

• Department of Traumatology, Clinic of Traumatology and Hand Surgery, Medical University in Wrocław

author

Witold Wnukiewicz

• Department of Traumatology, Clinic of Traumatology and Hand Surgery, Medical University in Wrocław

author

Piotr Mazurek

• Department of Traumatology, Clinic of Traumatology and Hand Surgery, Medical University in Wrocław

References

• Bahm J, Gilbert A: Surgical correction of supination deformity in children with obstetric brachial plexus palsy. J Hand Surg 2002; 27B: 20-23.
• Ozkan T, Aydin A, Ozer K et al.: A surgical technique for pediatric forearm pronation: brachioradialis rerouting with interosseous membrane release. J Hand Surg 2004; 29A: 22-27.
• Eberhard D: Transposition of the bicipital tuberosity for treatment of fixed supination contracture in obstetric brachial plexus lesions. J Hand Surg 1997; 22B: 261-63.
• Chuang DC, Ma HS, Wei FC: A new evaluation system to predict the sequelae of late obstetric brachial plexus palsy. Plast Reconstr Surg 1998, 101: 673-85.
• Liggio FJ, Tham S, Price A et al.: Outcome of surgical treatment for forearm pronation deformities in children with obstetric brachial plexus injuries. J Hand Surg 1999; 24B: 43-45.
• Blount WP: Osteoclasis for supination deformities in children. J Bone Joint Surg 1940; 22: 300-14.
• Al-Qattan MM: Assessment of the motor power in older children with obstetric brachial plexus palsy. J Hand Surg 2003; 28B: 46-49.
• Gilbert A: Long-term evaluation of brachial plexus surgery in obstetrical palsy. Hand Clin 1995; 11: 583-94.[PubMed]
• Price A, Grossman JA: A management approach for secondary shoulder and forearm deformities following obstetrical brachial plexus injury. Hand Clin 1995; 11: 607-17.[PubMed]
• Gosk J, Rutowski R, Szmida A: Okołoporodowe obrażenia splotu ramiennego. W: Czernik J (red.) Powikłania w chirurgii dziecięcej.: PZWL, Warszawa 2009; s. 297-313.
• Birch R: Obstetric brachial plexus palsy. J Hand Surg 2002; 27B: 3-8.
• Price A, Tidwell M, Grossman JA: Improving shoulder and elbow function in children with Erb's palsy. Sem Pediatr Neurol 2000; 7: 44-51.

Identifiers

DOI

10.2478/v10035-010-0092-z