TITLE:
Muscles Transfer around the Shoulder in Cases of Brachial Plexus Birth Palsy
AUTHORS:
Hesham El Sobkey
KEYWORDS:
Brachial Plexus, Tendon Transfer, Shoulder
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.9 No.3,
June
24,
2019
ABSTRACT: Background:Disabling internal rotation contractures are frequently experienced
in children with unresolved birth brachial plexus palsies. Multiple
surgical options like muscle release, tendon transfer, or humeral osteotomy
are available to treat such cases. Purpose:Evaluation of the outcome of subscapularis
release and latissimus dorsi and teres major tendon transfer in the
management of obstetric brachial palsies in Mansoura University neurosurgical
department. Study type: Retrospective observational study. Patients and Methods: Twenty-five cases who underwent subscapularis release and latissimus
dorsi and teres major transfer were included in the study. All patients
were subjected to complete history taking, through clinical examination. The
degree of shoulder movement and disability was assessed via Modified Gilbert
shoulder evaluation scale. Results: The least follow up period for our patients
was 9 months. There was a clear improvement of shoulder function
evaluated using Modified Gilbert shoulder evaluation scale as there were 73%
of postoperative group between GIV and GV while about 84% of preoperative
group were between GII and GIII. Conclusion: Tendon transfer is a valid easy
procedure for correction of shoulder deformities in patients with obstetrical
brachial plexus palsy. It is considered a very good option for patients who
missed the chance of microsurgical repair or patients with poor shoulder recovery
after surgery. Although some authors reported deterioration of shoulder
function with log time follow up after tendon transfer, it is still better
than those who were not operated.