Document Detail

Limb length differences after obstetrical brachial plexus injury: a growing concern.
MedLine Citation:
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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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  130     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2012-12-14     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  558e-571e     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Arm / growth & development*
Birth Injuries / epidemiology*,  physiopathology
Bone Diseases, Developmental / epidemiology*
Brachial Plexus / injuries*
Brachial Plexus Neuropathies / epidemiology*,  physiopathology
Case-Control Studies
Child, Preschool
Follow-Up Studies
Infant, Newborn
Longitudinal Studies
Monitoring, Physiologic / methods
Needs Assessment
Observer Variation
Prenatal Exposure Delayed Effects / epidemiology*
Prospective Studies
Reference Values
Risk Assessment
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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