%0 Journal Article
%T Clinical and neuropathological study about the neurotization of the suprascapular nerve in obstetric brachial plexus lesions
%A Dominique Schaakxs
%A J£¿rg Bahm
%A Bernd Sellhaus
%A Joachim Weis
%J Journal of Brachial Plexus and Peripheral Nerve Injury
%D 2009
%I Thieme Medical Publishers
%R 10.1186/1749-7221-4-15
%X We operated on 65 patients with obstetric brachial plexus palsy (OBPP), aged 5-35 months (average: 19 months). We assessed the recovery of passive and active external rotation with the arm in abduction and in adduction. We also looked at the influence of the restoration of the muscular balance between the internal and the external rotators on the development of a gleno-humeral joint dysplasia. Intraoperatively, suprascapular nerve samples were taken from 13 patients and were analyzed histologically.Most patients (71.5%) showed good recovery of the active external rotation in abduction (60¡ã-90¡ã). Better results were obtained for the external rotation with the arm in abduction compared to adduction, and for patients having only undergone the neurotization procedure compared to patients having had complete plexus reconstruction. The neurotization operation has a positive influence on the glenohumeral joint: 7 patients with clinical signs of dysplasia before the reconstructive operation did not show any sign of dysplasia in the postoperative follow-up.The neurotization procedure helps to recover the active external rotation in the shoulder joint and has a good prevention influence on the dysplasia in our sample. The nerve quality measured using histopathology also seems to have a positive impact on the clinical results.Brachial plexus lesions during birth affect one in 2000 newborns [1]. Ten percent of them need early or secondary surgical reconstruction [1]. In the treatment of obstetric brachial plexus lesions, one of the main problems is the poor recovery of abduction and external rotation in the shoulder joint [2].In children with upper and total brachial plexus lesions, the suprascapular nerve, the first motor branch of the upper trunk located in the center of the obstetric brachial plexus lesion, is usually affected. The clinical manifestation is the lack of active external rotation in the glenohumeral joint. The child adopts an internal rotation position and migh
%U http://www.jbppni.com/content/4/1/15