Outcome of Arthroscopic Subscapularis Release Combined with Latissmus Dorsi Tendon Transfer in Shoulder Deformity in Obstetrical Brachial Plexus Birth Palsy

Document Type : Original Article

Authors

Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Minia University, El-Minia, Egypt.

Abstract

Background
Rotational contracture deformity is a primary complication in pediatric brachial plexus birth palsy (BPBP), causing early functional disability and glenohumeral malformation. The current work aimed to assess the functional and radiological outcome after the combined arthroscopic release of the subscapularis tendon and latissimus dorsi tendon transfer to treat internal rotation contracture and adduction deformity of the shoulder joint after BPBP.
Study design
Retrospective single-center clinical study.
Patients and Methods
This study was conducted on 30 children with obstetrical BPBP. The mean age was 35 months (24–58 months). All patients were assessed clinically by measurement of passive external rotation and angle of abduction, radiologically by grading of glenoid dysplasia and functionally according to Mallet classification.
Results
Postoperative Range of motion was improved as the amplitude of external rotation (from –23° preoperatively to 47°), angle of abduction (from 50° preoperatively to 120°), and Mallet score significantly improved at final follow-up (P<0.001). No or mild glenoid dysplasia was reported. The surgical time was ranged between 40 and 70min. The follow-up ranged from 30 to 48 (average 39.3 months).
Conclusions
Combined arthroscopic total subscapularis release and latissmus dorsi tendon transfer is a simple and proper procedure for correcting glenohumeral disability after BPBP.

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