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HAND
Published in: HAND 4/2010

01-12-2010 | Original Article

Bone discrepancy as a powerful indicator for early surgery in obstetric brachial plexus palsy

Authors: Julia K. Terzis, Zinon T. Kokkalis

Published in: HAND | Issue 4/2010

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Abstract

Objectives

One of the unfortunate sequelae in obstetric brachial plexus palsy (OBPP) is upper limb length discrepancy. However, the influence of primary nerve reconstruction remains undetermined. In this study, the resultant discrepancy in children with OBPP who underwent primary reconstruction was analyzed in relation to the severity of the lesion, the timing of surgery, and the functional outcome following surgery.

Methods

Fifty-four patients that met the inclusion criteria were included in this study. Preoperative and postoperative bilateral scanograms were obtained to document the effect of reinnervation on bone growth. The length of the humerus, ulna, third metacarpal, third proximal phalange, and total limb length were measured and the percentage between the affected and normal side were accessed. Correlations between all the measures of limb length and measures of active motion (i.e., three different classification systems) were performed.

Results

Spearman’s rank correlation coefficients revealed significant correlations between limb length discrepancies and nearly all measures of active upper extremity movement. The timing of surgery and the severity of the lesion significantly influenced the resultant limb length discrepancy.

Conclusions

The prevention of a non-acceptable upper limb discrepancy is fundamental for both the patient and family. The extent of the resultant discrepancy appeared to be strongly related to the time between injury and surgery, degree of severity, and the outcome of surgery. Patients with better functional recoveries of the affected upper extremities showed smaller differences in limb length.
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Metadata
Title
Bone discrepancy as a powerful indicator for early surgery in obstetric brachial plexus palsy
Authors
Julia K. Terzis
Zinon T. Kokkalis
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
HAND / Issue 4/2010
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-010-9270-z

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