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International Orthopaedics
Published in: International Orthopaedics 4/2016

01-04-2016 | Original Paper

Subscapularis Z-lengthening in children with brachial plexus birth palsy loses efficiency at mid-term follow-up: a retrospective cohort study

Authors: Anne Sophie Kruit, Fouzia Choukairi, Anuj Mishra, Andrew Gaffey, Andrea Jester

Published in: International Orthopaedics | Issue 4/2016

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Abstract

Purpose

The aim of this study was to evaluate early and mid-term clinical outcomes after isolated subscapularis Z-lengthening in children with shoulder internal rotation contractures resulting from brachial plexus birth palsy.

Methods

Children with brachial plexus birth palsy treated with subscapularis tendon Z-lengthening from 2001 to 2011 were retrospectively reviewed. Over this period, 31 patients were identified. Primary outcome was improvement in Mallet score after surgery, and secondary outcome measures were active range of motion and Mallet sub-scores. Clinical outcomes were collected at three time intervals: pre-operatively, one-year post-operative and at latest follow-up.

Results

After exclusion, 21 patients remained for further analysis. Mean age at surgery was 3.7 years (range, 1.2–8.7), and mean follow-up length was 6.5 years (2.9–9.7). Moderate improvements were found for mean Mallet score, active external rotation, active abduction and hand-to-mouth movement at one year and latest follow-up. However, improvements in active external rotation and Mallet score were not fully maintained at final follow up.

Conclusion

Isolated subscapularis Z-lengthening is effective at early follow-up, but results are not maintained at mid-term follow-up.
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Metadata
Title
Subscapularis Z-lengthening in children with brachial plexus birth palsy loses efficiency at mid-term follow-up: a retrospective cohort study
Authors
Anne Sophie Kruit
Fouzia Choukairi
Anuj Mishra
Andrew Gaffey
Andrea Jester
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-3062-6

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