Roberta de Matos Figueiredo1, Giuliana Grechi2, Ricardo de Amoreira Gepp3. 1. Sarah Network of Hospitals, SMHS Q. 501 Conj. A, Brasilia, DF, 70335-901, Brazil. robertamf@sarah.br. 2. Sarah Network of Hospitals, SMHS Q. 501 Conj. A, Brasilia, DF, 70335-901, Brazil. giulianagrechi@gmail.com. 3. Sarah Network of Hospitals, SMHS Q. 501 Conj. A, Brasilia, DF, 70335-901, Brazil.
Abstract
PURPOSE: Most cases of obstetric brachial plexus palsy (OBPP) involve C5 and C6 nerve roots (Erb's palsy). In those cases, re-establishing the elbow flexion is the primary goal of surgery. The partial transfer of the ulnar nerve to the musculocutaneous nerve (Oberlin's procedure) is widely used in adults, but incipient in children. The purpose of this study is to describe the results obtained with such procedure as regards the improvement of the elbow flexion and donor nerve morbidity. METHOD: Thirteen children aged 9 to 15 months underwent Oberlin's procedure. They were assessed preoperatively and 1 year postoperatively using the active movement scale and also according to the functionality of the affected limb. All of them were evaluated because of the possibility of movement loss resulting from the donor nerve. We used the non-parametric, statistic Wilcoxon signed rank test (α = 0,05) method. RESULTS: There was a significant improvement in the active elbow flexion between pre- and postoperative periods. Eleven children presented functional improvement. All of them maintained negative cookie test 1 year after the surgery. We did not observe any loss related to the donor nerve in terms of wrist flexion. CONCLUSION: The results suggest that Oberlin's procedure can be an effective and safe alternative to treat elbow flexion in Erb's palsy.
PURPOSE: Most cases of obstetric brachial plexus palsy (OBPP) involve C5 and C6 nerve roots (Erb's palsy). In those cases, re-establishing the elbow flexion is the primary goal of surgery. The partial transfer of the ulnar nerve to the musculocutaneous nerve (Oberlin's procedure) is widely used in adults, but incipient in children. The purpose of this study is to describe the results obtained with such procedure as regards the improvement of the elbow flexion and donor nerve morbidity. METHOD: Thirteen children aged 9 to 15 months underwent Oberlin's procedure. They were assessed preoperatively and 1 year postoperatively using the active movement scale and also according to the functionality of the affected limb. All of them were evaluated because of the possibility of movement loss resulting from the donor nerve. We used the non-parametric, statistic Wilcoxon signed rank test (α = 0,05) method. RESULTS: There was a significant improvement in the active elbow flexion between pre- and postoperative periods. Eleven children presented functional improvement. All of them maintained negative cookie test 1 year after the surgery. We did not observe any loss related to the donor nerve in terms of wrist flexion. CONCLUSION: The results suggest that Oberlin's procedure can be an effective and safe alternative to treat elbow flexion in Erb's palsy.
Authors: Carlos O Heise; Mario G Siqueira; Roberto S Martins; Luciano H Foroni; Hugo Sterman-Neto Journal: Childs Nerv Syst Date: 2017-06-24 Impact factor: 1.475
Authors: Eduardo Araújo Figueiredo; Fernando Sellitti Chiabai de Freitas; Júlio Inácio Parente Neto; Yussef Ali Abdouni; Antônio Carlos da Costa Journal: Rev Bras Ortop (Sao Paulo) Date: 2022-01-21