Document Detail

Long-term outcomes of triangle tilt surgery for obstetric brachial plexus injury.
MedLine Citation:
PMID:  20130887     Owner:  NLM     Status:  MEDLINE    
AIM: The purpose of this study was to evaluate long-term shoulder functional outcomes from a triangle tilt procedure on obstetric patients, who initially presented with medial rotation contracture and scapular deformity secondary to obstetric brachial plexus injury. METHODS: We retrospectively studied long-term outcomes both functionally and anatomically in 61 patients (age ranging from 2 to 12 years). Functional movements were evaluated and scored using a modified Mallet scale at different time intervals: preoperatively, 1 year and 2 year following triangle tilt surgery. Shoulder anatomy was examined on radiologic images to evaluate the severity of shoulder deformities preoperatively and anatomical improvement after the surgery. RESULTS: All shoulder functional movements were significantly improved at 1 and 2 year follow-ups. Functional improvements were maintained in shoulder abduction, external rotation and hand-to-mouth movements beyond the first year, and continued in hand-to-neck and hand-to-spine movements past 2 years. Remarkable glenohumeral remodeling or reservation of glenoid congruence was observed in all patients over a mean time of 27 months postoperatively. CONCLUSION: The triangle tilt procedure, which addresses scapular and glenohumeral joint abnormalities characteristic of Erb's palsy, improves shoulder functional movements and anatomical structure in patients over the long-term.
Rahul K Nath; Xiaomei Liu; Sonya E Melcher; Jilao Fan
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Publication Detail:
Type:  Journal Article     Date:  2010-02-04
Journal Detail:
Title:  Pediatric surgery international     Volume:  26     ISSN:  1437-9813     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-18     Completed Date:  2010-06-24     Revised Date:  2010-09-28    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  393-9     Citation Subset:  IM    
Texas Nerve and Paralysis Institute, Houston, USA.
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MeSH Terms
Birth Injuries / complications,  radiography,  surgery*
Brachial Plexus / injuries*,  radiography,  surgery*
Brachial Plexus Neuropathies / etiology,  radiography,  surgery*
Child, Preschool
Contracture / etiology,  radiography,  surgery*
Follow-Up Studies
Range of Motion, Articular
Reconstructive Surgical Procedures / methods*
Retrospective Studies
Severity of Illness Index
Shoulder Joint / radiography,  surgery
Treatment Outcome

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

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