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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Outcome of Tendon Transfer Around Shoulder with Erb’s Palsy Internal Rotation Deformity

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  • presenting/speaker Farouk Hamad - Orthopaedic Department,Faculty of Medicine,Tanta University, Tanta, Egypt
  • Muhammad Romeih - Orthopaedic Department,Faculty of Medicine,Tanta University, Tanta, Egypt
  • Mostafa Ayoub - Orthopaedic Department,Faculty of Medicine,Tanta University, Tanta, Egypt

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-477

doi: 10.3205/19ifssh1412, urn:nbn:de:0183-19ifssh14127

Published: February 6, 2020

© 2020 Hamad et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Obstetric Brachial Plexus Palsy (OBPP) is one of the most severe complications at birth with internal rotation deformity that have significant functional disability. There is a many different methods of tendon transfer that have been descried to improve the shoulder Range of Motion (ROM).

Objectives of Study: Evaluate the outcome of teres major tendon transfer around the shoulder in children with Erb's palsy internal rotation deformity.

Methods: This study was Retrospective and Prospective randomized clinical study carried out on totally (25) patients admitted to Orthopaedic Department of Tanta University Hospital. Ten children represented the Retrospective portion of the study, and fifteen represented the prospective portion. All cases were operated by Modified Sever-L'Episcopo technique. The external rotation, according to Mallet score, was recorded pre-and post-operatively.

Results and Conclusions: The mean follow-up period was twelve months (range 6-18). The Mallet score for the shoulder external rotation, at the end of follow-up periods, was graded as Grade II in two patients (8%), Grade III in nine patients (36%), and Grade IV in fourteen patients (56%). There was a highly significant improvement (p=0.00001) of the external rotation range as the mean pre-operative score was 2.04±0.02, and the mean post-operative score was 3.48±0.65.

The Modified Sever L'Episcopo procedure that compromises of anterior release, then teres major tendon transfer to the tendon of infraspinatus shows a high incidence of good outcome with a promising subjective and objective improvement in almost cases.