Long-Term Results of Surgery for Brachial Plexus Birth Palsy

• DOI: 10.2106/jbjs.e.00430
• Publication Date: 2007-01-03T15:52:05Z
• Authors: Mikko Kirjavainen; Ville Remes; Jari Peltonen; Pentti Kinnunen; Tiina Pöyhiä; Timo Telaranta; Markku Alanen; Ilkka Helenius; Yrjänä Nietosvaara
• Keywords: Adult; Joint Instability; Adolescent; Shoulder Joint; Infant; Pain; Hand; 3. Good health; Disability Evaluation; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Child, Preschool; Activities of Daily Living; Elbow Joint; Humans; Brachial Plexus Neuropathies; Child; Finland; Follow-Up Studies; Retrospective Studies

Background: The long-term results of surgical treatment brachial plexus birth palsy have not been reported. We present the findings a nationwide study, with minimum five-year follow-up, outcomes surgery for in Finland. Methods: Of 1,717,057 newborns, 1706 requiring hospital were registered Finland between 1971 and 1997. these patients, 124 (7.3%) underwent on at mean age 2.8 months (range, 0.4 to 13.2 months). most commonly performed procedure was direct neurorrhaphy after neuroma resection. One hundred twelve patients (90%) returned clinical radiographic follow-up examination 13.3 years. Activities daily living recorded questionnaire, affected limb assessed use joint-specific functional measures. Results: Two-thirds (63%) satisfied outcome, although one-third all needed help activities living. One-third including nine clavicular nonunion from approach, experienced pain limb. All except four used hand unaffected as dominant hand. Shoulder function moderate, Mallet score 3.0. Both elbow good, Gilbert scale 3 Raimondi 4. Incongruence glenohumeral joint noted sixteen (16%) ninety-nine whom it assessed, incongruence radiohumeral twenty-one (21%). extent injury found be strongly associated final shoulder, elbow, multivariate analysis. Conclusions: Following palsy, substantial numbers continued need performing had limb, due one-fourth patients. strongest prognostic factor predicting outcome appears primary injury. Level Evidence: Therapeutic III. See Instructions Authors complete description levels evidence.