gms | German Medical Science

Objectives/Interrogation: Among birth brachial plexus injury sequelae, the lack of external rotation is common and responsible of clairon sign, which impair the whole upper limb. The shoulder was fixed in medial rotation thanks to external rotators weakness and medial soft tissue retraction. The humeral external osteotomy with muscles transfer was usually applied, but still not achieving correction in every kind of shoulder deformities, more over with results loss through time life.

In this prospective study, we aim to evaluate the functional and anatomic results of late anterior release of old child and teenager.

Methods: Our series included 8 patients (1 male and 7 females), aged from 9 to 17 y.o. with different level of plexus injury. The follow up were from 1 to 36 months. The clairon sign was constant, associated sometimes to elbow, forearm and hand impairment. All of them had daily living and clothing difficulties with lack of autonomy, eating, and hygiene. Also suffering from cosmetics, less strength, and pain, involving social live and school education.

Patients were assessed at follow up regarding life quality enhancement, daily living, clairon sign correction, mallet score, range of movement, satisfaction and radiology results.

Results and Conclusions: We had five good results and patients were improved in terms of all criteria's, and three of them with total plexus injury sequela had mild and bad results.

Our results of late anterior shoulder release in birth plexus injury are promising, and enable us to avoid sometimes using muscles transfer and humeral osteotomy in late childhood which neglect dislocation correction.