Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
FIRPO, Carlos A. N.; MIRANDA, Hugo y FRANZOSI, Nicolás. Shoulder deformities and sequelae secondary to brachial plexus birth palsy. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.3, pp. 236-243. ISSN 1852-7434.
Background: This infrequent pathology calls for broad experience and knowledge. The paper describes the clinical findings and treatment outcome. Methods: We evaluated 92 brachial plexus birth palsy patients requiring surgical treatment during 25 years; 67 present bone deformities and 31 soft tissue deformities.A retrospective, clinical-functional, analytical and descriptive methodology was used.We reviewed clinical records and personal observations. We followed the Bennett and Christopher algorhitm. When indicated we performed early plexus microsurgery. At 4 years post-op a secondary reconstruction might be necessary in certain cases. The limb was assessed with maneuvers and the DLA. Results: Our goal is to provide active abduction and external rotation. Different procedures were employed: early brachial plexus repair and palliative surgery. For such different pathologies that require varied surgical techniques the results will be considered in overall percentages. We achieved 80% functional improvement in C5-C6 and even C7 lesions. Conclusions: In birth palsy, microsurgical repair improves results. The Roper technique improves limb function. Studies indicate that children with severe injuries do better with both, i.e. primary and secondary surgical treatment. In C5-C6 lesions, it is possible to obtain up to 80% recovery.
Palabras llave : Birth palsy; Brachial plexus birth palsy; Obstetrical paralysis sequelae; Shoulder sequelae.