期刊论文详细信息
BMC Musculoskeletal Disorders
The effect of perinatal brachial plexus lesion on upper limb development
Maciej Urban1  Witold Wnukiewicz1  Jerzy Gosk1 
[1]Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland
关键词: Reconstruction;    Limb girth discrepancy;    Limb length discrepancy;    Brachial plexus palsy;   
Others  :  1127769
DOI  :  10.1186/1471-2474-15-116
 received in 2013-07-29, accepted in 2014-03-25,  发布年份 2014
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【 摘 要 】

Background

Deficiency in upper limb development is a sequel of the perinatal brachial plexus palsy. The purpose of this study was to evaluate the effect of brachial plexus birth lesion on upper limb development.

Methods

Forty-four patients with unilateral obstetric brachial plexus palsy underwent measurements of both upper extremities. The average age at the time of evaluation was 6.8 years. Active motion was assessed using Gilbert-Raimondi, the modified MRC, and Al-Qattan scales. Paired t test was used for statistical analysis. Correlation between limb length / circumference discrepancy and age / time of surgery was assessed using Pearson correlation coefficient.

Results

A decrease in the circumference and length was observed in all limbs with brachial plexus lesion. We found a statistically significant difference between degree of hand length and width decrease and its useful and useless function. We observed a statistically significant difference in measurement: forearm length, hand length and width dependent on the type of surgical procedure (neurolysis, reconstruction). We observed no correlation between age and limb length / circumference discrepancy. We also observed no correlation between time of surgery and limb length / circumference discrepancy.

Conclusions

The decrease in dimensions of the affected limbs occurred predominantly during the period of early childhood. Disparities in dimensions are observed in both cases of deficiency of useful function of upper limb and cases in which functional efficiency appears.

【 授权许可】

   
2014 Gosk et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Birch R: Obstetric brachial plexus palsy. J Hand Surg Br 2002, 27:3-8.
  • [2]Bisinella GL, Birch R: Obstetric brachial plexus lesions: a study of 74 children registered with the British Paediatric Surveillance Unit (March 1998-March 1999). J Hand Surg Br 2003, 28:40-45.
  • [3]Clarke HM, Curtis CG: An approach to obstetrical brachial plexus injuries. Hand Clin 1995, 11:563-580.
  • [4]Eng GD, Binder H, Getson P, O'Donnell R: Obstetrical brachial plexus palsy (OBPP) outcome with conservative management. Muscle Nerve 1996, 19:884-891.
  • [5]Gilbert A, Berger A: General concept and conclusions regarding treatment of traumatic brachial plexus birth injury lesions. Orthopade 1997, 26:729-730.
  • [6]Gosk J, Rutowski R: Primary repair procedures in perinatal brachial plexus palsy - own experience. Pol Przegl Chir 2006, 78:1361-1367.
  • [7]Grossman JA: Early operative intervention for birth injuries to the brachial plexus. Semin Pediatr Neurol 2000, 7:36-43.
  • [8]Haerle M, Gilbert A: Management of complete obstetric brachial plexus lesions. J Pediatr Orthop 2004, 24:194-200.
  • [9]Kirjavainen M, Remes V, Peltonen J, Kinnunen P, Pöyhiä T, Telaranta T, Alanen M, Helenius I, Nietosvaara Y: Long-term results of surgery for brachial plexus birth palsy. J Bone Joint Surg Am 2007, 89:18-26.
  • [10]Bae DS, Ferretti M, Waters PM: Upper extremity size differences in brachial plexus birth palsy. Hand (N Y) 2008, 3:297-303.
  • [11]Chuang DC, Ma HS, Wei FC: A new evaluation system to predict the sequelae of late obstetric brachial plexus palsy. Plast Reconstr Surg 1998, 101:673-685.
  • [12]McDaid PJ, Kozin SH, Thoder JJ, Porter ST: Upper extremity limb-length discrepancy in brachial plexus palsy. J Pediatr Orthop 2002, 22:364-366.
  • [13]Terzis JK, Kokkalis ZT: Bone discrepancy as a powerful indicator for early surgery in obstetric brachial plexus palsy. Hand (N Y) 2010, 5:386-396.
  • [14]Anand P, Birch R: Restoration of sensory function and lack of long-term chronic pain syndromes after brachial plexus injury in human neonates. Brain 2002, 125:113-122.
  • [15]Al-Qattan MM: Assessment of the motor power in older children with obstetric brachial plexus palsy. J Hand Surg Br 2003, 28:46-49.
  • [16]Carr-Hyde RA, Wessely MA: “Waiter’s tip” (Erb’s) palsy: a case report and literature review. Clin Chiropr 2003, 6:34-41.
  • [17]Bellew M, Kay SP: Early parental experiences of obstetric brachial plexus palsy. J Hand Surg Br 2003, 28:339-346.
  • [18]Bellew M, Kay SP, Webb F, Ward A: Developmental and behavioural outcome in obstetric brachial plexus palsy. J Hand Surg Br. 2000, 25:49-51.
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