Charline Garcon1, Hicham Abdelnour1, Clément Jeandel2, Djamel Louahem2, Isabelle Laffont3,4, Jérôme Cottalorda2, Karen Lambert5, Bertrand Coulet1,4, Marion Delpont6,7. 1. Department of Hand and Upper Extremity Surgery, Peripheral Nerves Surgery, Lapeyronie Hospital, University of Montpellier, Montpellier, France. 2. Department of Pedriatric Orthopedic Surgery, Lapeyronie Hospital, University of Montpellier, 191 av du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. 3. Department of Physical Medicine and Rehabilitation, University of Montpellier, Montpellier, France. 4. EuroMov Digital Health in Motion, University of Montpellier, Montpellier, France. 5. PhyMedExp, CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France. 6. Department of Pedriatric Orthopedic Surgery, Lapeyronie Hospital, University of Montpellier, 191 av du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. m-delpont@chu-montpellier.fr. 7. PhyMedExp, CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France. m-delpont@chu-montpellier.fr.
Abstract
PURPOSE: Quantifying changes in shoulder external rotation range of motion and strength after lower trapezius transfer in children with obstetric brachial plexus palsy (OBPP). METHODS: This prospective study included five children with sequelae of OBPP, with a mean age of 6.4 years (range: 4-12 years) who underwent lower trapezius tendon transfer to restore active external rotation (ER) of the shoulder. Pre-operatively and at a 12-month follow-up assessment, we analyzed the passive and active shoulder ER, the modified Mallet score, and the shoulder rotator muscles strength using an isokinetic device. RESULTS: Clinical parameters improved significantly after trapezius transfer pre-operative passive ER from -8° (range: -20-0°) to 37° (range: 15-50°) (p = 0.035), the modified Mallet score from 13 (range: 10-15) to 18 (range: 17-19) (p = 0.035). Strength testing revealed improved ER muscle strength in all five cases; the mean Peak Torque increased from 1.95 to 4.46 N·m, albeit non-significantly (p = 0.062). Two patients exhibited a winged scapula post-operatively. CONCLUSION: Lower trapezius transfer seems encouraging to restore shoulder external rotation in OBPP children but with non-significant strength improvement. TRIAL REGISTRATION: 18/07/31/5783, December 22, 2018.
PURPOSE: Quantifying changes in shoulder external rotation range of motion and strength after lower trapezius transfer in children with obstetric brachial plexus palsy (OBPP). METHODS: This prospective study included five children with sequelae of OBPP, with a mean age of 6.4 years (range: 4-12 years) who underwent lower trapezius tendon transfer to restore active external rotation (ER) of the shoulder. Pre-operatively and at a 12-month follow-up assessment, we analyzed the passive and active shoulder ER, the modified Mallet score, and the shoulder rotator muscles strength using an isokinetic device. RESULTS: Clinical parameters improved significantly after trapezius transfer pre-operative passive ER from -8° (range: -20-0°) to 37° (range: 15-50°) (p = 0.035), the modified Mallet score from 13 (range: 10-15) to 18 (range: 17-19) (p = 0.035). Strength testing revealed improved ER muscle strength in all five cases; the mean Peak Torque increased from 1.95 to 4.46 N·m, albeit non-significantly (p = 0.062). Two patients exhibited a winged scapula post-operatively. CONCLUSION: Lower trapezius transfer seems encouraging to restore shoulder external rotation in OBPP children but with non-significant strength improvement. TRIAL REGISTRATION: 18/07/31/5783, December 22, 2018.
Authors: Scott H Kozin; Matthew J Boardman; Ross S Chafetz; Gerald R Williams; Alexandra Hanlon Journal: J Shoulder Elbow Surg Date: 2010-01 Impact factor: 3.019
Authors: A Abid; J Kany; F Accadbled; P Darodes; G Knorr; J Sales de Gauzy; J-P Cahuzac Journal: Rev Chir Orthop Reparatrice Appar Mot Date: 2008-04-01
Authors: Agnes F Hoeksma; Anne Marie ter Steeg; Rob G H H Nelissen; Willem J R van Ouwerkerk; Gustaaf J Lankhorst; Bareld A de Jong Journal: Dev Med Child Neurol Date: 2004-02 Impact factor: 5.449