Active Range of Motion Over Time in Patients With Obstetrical Brachial Plexus Palsy: A 10-Year Analysis

J Hand Surg Am. 2018 Apr;43(4):386.e1-386.e7. doi: 10.1016/j.jhsa.2017.10.024. Epub 2017 Nov 21.

Abstract

Purpose: In our experience, and from the personal report of others, children with obstetrical brachial plexus palsy appear to lose some of their initially recovered active range of motion over the time in both operated and nonsurgical patients. This study investigates whether such a diminution of active movement occurs over time.

Methods: We performed a retrospective analysis of data from our obstetrical brachial plexus clinic. Between 1991 and 2000, 139 patients with a minimum follow-up of 10 years were included in the study. Patients were divided into a nonsurgical group (n = 42) and a group who underwent either primary or secondary brachial plexus reconstruction or both (n = 97). Fifteen joint movements were assessed at 2, 4 to 6, and 9 to 11 years of age and at later final follow-up using the Active Movement Scale. Repeated measures analysis using age at each visit as the repeated measures covariate was undertaken.

Results: Active movement scores were not diminished when patients were evaluated at the 10-year follow-up visit.

Conclusions: The suggested loss of active range of motion over time is not demonstrated at 10-year follow-up.

Type of study/level of evidence: Prognostic III.

MeSH terms

  • Birth Injuries / physiopathology
  • Brachial Plexus / injuries*
  • Brachial Plexus / physiopathology
  • Brachial Plexus Neuropathies / physiopathology*
  • Brachial Plexus Neuropathies / therapy
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Joints / physiopathology*
  • Joints / surgery
  • Orthopedic Procedures
  • Range of Motion, Articular / physiology*
  • Retrospective Studies
  • Upper Extremity / physiopathology*
  • Upper Extremity / surgery