Bilateral Elbow Flexion Reconstruction with Functioning Free Muscle Transfer for Obstetric Brachial Plexus Palsy

2002 ◽  
Vol 27 (5) ◽  
pp. 484-486 ◽  
Author(s):  
A. S. BALIARSING ◽  
K. DOI ◽  
Y. HATTORI
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Gracilis Muscle ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Nerve Roots ◽  
Obstetric Brachial Plexus Palsy ◽  
Shoulder Joints ◽  
Muscle Transfers ◽  
Obstetric Brachial Plexus

A child suffered a bilateral obstetric brachial plexus palsy involving the C5 and C6 nerve roots. Abduction of the shoulder joints had recovered by 1 year, but elbow flexion did not recover on either side. Free gracilis muscle transfers were performed on both sides, at an interval of 6 months, to achieve elbow flexion. The spinal accessory nerve was used as the donor nerve.

Obstetric Brachial Plexus Palsy in Newborn Babies of Diabetic and Non-Diabetic Mothers

2010 ◽  
Vol 35 (5) ◽  
pp. 362-365 ◽  
Author(s):  
M.M. Al-Qattan ◽  
A.A.F. El-Sayed ◽  
A.Y. Al-Zahrani ◽  
S.A. Al-Mutairi ◽  
M.S. Al-Harbi ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Spontaneous Recovery ◽  
External Rotation ◽  
Elbow Flexion ◽  
Motor Power ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus ◽  
Shoulder External Rotation ◽  
Diabetic Mothers

Compared to non-diabetic mothers, diabetic mothers are known to deliver larger babies who are at higher risk for shoulder dystocia and obstetric brachial plexus palsy. The intrapartum forces applied during delivery of larger babies are expected to be higher. Hence, the chances of these babies for good spontaneous recovery are expected to be lower; and this is a generally believed hypothesis. The objective of this retrospective study was to compare obstetric brachial plexus palsy in newborn babies of diabetic and non-diabetic mothers. There were a total of 655 cases of obstetric palsy: 253 cases with diabetic mothers and 402 with non-diabetic mothers. The former were more likely to develop total palsy while the latter were more likely to develop extended Erb’s palsy. Newborn babies of diabetic mothers had significantly larger birth weights than those of non-diabetic mothers regardless of the type of palsy. The rate of good spontaneous recovery of the motor power of the limb in the two groups was not significantly different except in total palsy cases for shoulder external rotation and elbow flexion where the recovery was significantly better in the diabetic group. It was concluded that the generally believed hypothesis is not correct if one compares the outcome in the diabetic and non-diabetic groups for each type of palsy.

Elbow Flexion Reconstruction by Steindler Flexorplasty in Obstetric Brachial Plexus Palsy

2005 ◽  
Vol 30 (4) ◽  
pp. 424-427 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Selection Criteria ◽  
Elbow Flexion ◽  
Drill Hole ◽  
Flexion Contracture ◽  
Brachial Plexus Palsy ◽  
Older Children ◽  
Obstetric Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus

The results of Steindler flexorplasty in nine patients with obstetric brachial plexus palsy are reported. There were 5 girls and 4 boys with a mean age of 6 (range 2–13) years. Selection criteria for the procedure included strong (at least M4) grip strength and wrist and elbow extension, as well as the presence of the “Steindler effect”. Pre-operatively, elbow flexion was rated as M0 or M1 in three patients and M2 in the remaining six patients. Intra-operatively, the detached common flexor origin was advanced 5 to 7 cm and fixation was done to the anterior humerus either with direct suture to the periosteum (in younger children) or suturing into a drill hole in the humerus (in older children). Postoperatively, the elbow was immobilized in flexion and supination for 6 weeks. At a mean follow-up of 5 years, the results in eight patients were good with mean active elbow flexion against resistance of 110° and a mean elbow flexion contracture of 35°. The result in the remaining patient was poor (unsuccessful transfer). It is concluded that the results of the Steindler flexorplasty in obstetric brachial plexus palsy patients are good and reliable, provided patient selection is careful.

Brachialis Muscle Transfer to the Forearm Muscles in Obstetric Brachial Plexus Palsy

2006 ◽  
Vol 31 (3) ◽  
pp. 261-265 ◽  
Author(s):  
J. A. BERTELLI
Keyword(s):  
Brachial Plexus ◽  
Hand Function ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Wrist Extension ◽  
Active Motion ◽  
Obstetric Brachial Plexus Palsy ◽  
Brachialis Muscle ◽  
Obstetric Brachial Plexus ◽  
Extensor Carpi Radialis

Tendon transfers are frequently needed to improve hand function in obstetric brachial plexus injuries. The reconstruction cannot always be achieved using local donor transfers in the forearm as these are not always available. In such cases, we propose the use of the brachialis muscle as a useful donor for transfer. Five adolescents with obstetric brachial plexus palsy were operated on to reconstruct wrist extension and/or pronation using the brachialis muscle transfer to the pronator teres ( n = 1) extensor carpi radialis brevis ( n = 1) and extensor carpi radialis longus ( n = 3). Twelve months after surgery, average active motion recovery was 20° for wrist extension and 14° for pronation. Active and passive range of motion was similar.

scholarly journals Evidence of the Effectiveness of Primary Brachial Plexus Surgery in Infants With Obstetric Brachial Plexus Palsy–Revisited

2017 ◽  
Vol 4 ◽  
pp. 2329048X1770939 ◽  
Author(s):  
Amel A. F. El-Sayed
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Motor Recovery ◽  
Brachial Plexus Palsy ◽  
Obstetric Brachial Plexus Palsy ◽  
Primary Surgery ◽  
Obstetric Brachial Plexus ◽  
Brachial Plexus Surgery ◽  
Surgical Group

A recent systematic review questioned the effectiveness of primary surgery in infants with obstetric brachial plexus palsy. At our center, the indication for primary surgery in infants with upper Erb’s obstetric palsy is the lack of active elbow flexion at age 4 months. The current study compares the outcome of motor recovery in 2 groups of infants with upper Erb’s palsy: one group (n = 9) treated surgically between age 4 and 5 months, and another group (n = 9) treated conservatively despite the lack of active elbow flexion at age 4 months. The only reason for not doing the surgery in the latter group was refusal by the parents. The scores of motor recovery were collected at the 2-year follow-up visit, and they were significantly better in the surgical group. The study demonstrates the effectiveness of primary surgery in infants with upper Erb’s obstetric palsy compared to conservative management.

scholarly journals Outcome of free gracilis muscle transfer for the restoration of elbow flexion in traumatic brachial plexus palsy

2021 ◽  
Vol 32 (3) ◽  
pp. 633-641
Author(s):  
Mehmet Armangil ◽  
Seyyid Şerif Ünsal ◽  
Tuğrul Yıldırım ◽  
Uğur Bezirgan ◽  
Anar Keremov ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Gracilis Muscle ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer
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