Article: article from journal or magazin.
Outcome of subscapularis muscle release for shoulder contracture secondary to brachial plexus palsy at birth.
Journal of Pediatric Orthopedics
Children with unresolved brachial plexus palsy frequently develop a disabling internal rotation contracture of the shoulder. Several surgical options, including soft tissue procedures such as muscle releases and/or transfers, and bone operations such as humeral osteotomy are available to correct this deformity. This study describes the effect of subscapularis muscle release performed in isolation. Thirteen patients (5 boys, 8 girls) were reviewed at an average of 3.5 years after their surgery (range, 2-7 years). Their mean age at operation was 4.7 years (range, 1-8 years). Three children had C5-C6 palsies, 8 had C5-C7 palsies, and 2 had C5-C8 palsies. Postoperatively, patients presented significant gains in shoulder active lateral rotation (+49 degrees, from 5 to 54 degrees), active abduction (+30 degrees, from 63 to 93 degrees), active flexion (+46 degrees, from 98 to 144 degrees), and active extension (+23 degrees, from 7 to 30 degrees). Gains were also observed in passive range of motion, but of a lesser degree. Subscapularis muscle release is a procedure we found to have few significant complications and was highly effective in increasing active range of motion and restoring shoulder function.
Brachial Plexus/injuries, Brachial Plexus Neuropathies/physiopathology, Brachial Plexus Neuropathies/surgery, Child, Child, Preschool, Contracture/surgery, Female, Humans, Infant, Male, Muscle, Skeletal/surgery, Paralysis, Obstetric/physiopathology, Paralysis, Obstetric/surgery, Range of Motion, Articular, Retrospective Studies, Shoulder Joint/physiopathology, Treatment Outcome
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