|Limb length differences after obstetrical brachial plexus injury: a growing concern.|
|PMID: 23018717 Owner: NLM Status: MEDLINE|
|BACKGROUND: Residual size discrepancy between the affected and unaffected limbs is a distinct but not well-understood consequence of an obstetrical brachial plexus injury. This study aimed to document the extent of limb length differences in children with obstetrical brachial plexus injury compared with typically developing children. The effects of age, growth patterns, severity, and surgical intervention were also explored. Also, this study examined the reliability of the clinical measurement technique.
METHODS: A prospective cohort of 179 children with obstetrical brachial plexus injury was systematically evaluated for limb length and girth by a multidisciplinary team. Clinical measurements were obtained at regular intervals until 12 months and then yearly. A control group of typically developing children aged 6 months to 17 years had limb length and girth measured on one occasion.
RESULTS: Interrater reliability of clinical measurement techniques demonstrated high consistency, with an intraclass correlation of 0.90 (p < 0.0001). Limb measurements were recorded at nine time points. Paired t tests of children with and without surgical intervention found significant differences between affected and unaffected sides in arm, forearm, and total length as early as the 1-month measurement and at most other time points (p < 0.05). The 3-month total limb length difference was a statistically significant predictor of 12-month limb length difference (p < 0.05).
CONCLUSIONS: Obstetrical brachial plexus injury significantly affects the length of the arm and forearm. Early detectable limb length deficits are associated with the likelihood of requiring surgical reconstruction. Clinical limb length measurement can be performed reliably and noninvasively.
|James R Bain; Carol DeMatteo; Deborah Gjertsen; Tara Packham; Victoria Galea; Jessica A Harper|
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|Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't|
|Title: Plastic and reconstructive surgery Volume: 130 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2012 Oct|
|Created Date: 2012-09-28 Completed Date: 2012-12-14 Revised Date: 2013-08-06|
Medline Journal Info:
|Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States|
|Languages: eng Pagination: 558e-571e Citation Subset: AIM; IM|
|Division of Plastic Surgery, Department of Surgery, the School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.|
|APA/MLA Format Download EndNote Download BibTex|
Arm / growth & development*
Birth Injuries / epidemiology*, physiopathology
Bone Diseases, Developmental / epidemiology*
Brachial Plexus / injuries*
Brachial Plexus Neuropathies / epidemiology*, physiopathology
Monitoring, Physiologic / methods
Prenatal Exposure Delayed Effects / epidemiology*
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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