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DOI: 10.1055/s-2004-837255
Surgical Strategy in Obstetric Brachial Plexus Palsy: The Aachen Experience
Publikationsverlauf
Publikationsdatum:
06. Dezember 2004 (online)
ABSTRACT
We present our personal experience with 650 children suffering from obstetric brachial plexus palsy. We describe the related surgery including early microsurgical nerve reconstruction and later tendon and muscle transfers. We discuss our clinical approach, the indications and timing for surgery, the technical details of primary and secondary surgery in our hands, and the possible outcome. We emphasize that both clinical work and research work need an interdisciplinary team approach and that diagnostic, therapeutic, and prognostic improvement is based on the refinements of our (micro)surgical skill and the continuous exchange of information between specialized centers.
KEYWORDS
Obstetric brachial plexus palsy - microsurgery - tendon/muscle transfers - cocontraction - movement analysis
REFERENCES
- 1 Bahm J. Obstetric brachial plexus palsy-clinics, pathophysiology and surgical treatment. Handchir Mikrochir Plast Chir. 2003; 35 83-97
- 2 Gilbert A, Hentz V R, Tassin F L. Brachial plexus reconstruction in obstetric palsy: operative indications and postoperative results. In: Urbaniak JR Microsurgery for Major Limb Reconstruction. St Louis; Mosby 1987: 348-364
- 3 Borrero J L, De Pawlikowski W. Obstetrical Brachial Plexus Palsy. Lima; Althaus 2002
- 4 Millesi H, Rath T, Reihsner R, Zöch G. Microsurgical neurolysis: its anatomical and physiological basis and its classification. Microsurgery. 1993; 14 430-439
- 5 Clarke H M, Al-Qattan M M, Curtis C G, Zuker R M. Obstetrical brachial plexus palsy-results following neurolysis of conducting neuromas-in-continuity. Plast Reconstr Surg. 1996; 97 974-984
- 6 Terzis J K, Papakonstantinou K C. Management of obstetric brachial plexus palsy. Hand Clin. 1999; 15 717-736
- 7 Birch R. Medial rotation contracture and posterior dislocation of the shoulder. In: Gilbert A Brachial Plexus Injuries. London; Martin Dunitz 2001: 249-260
- 8 Hoffer M M, Wickenden R, Roper B. Brachial plexus birth palsies-results of tendon transfers to the rotator cuff. J Bone Joint Surg Am. 1978; 60 691-695
- 9 Gilbert A, Romana C, Ayatti R. Tendon transfers for shoulder paralysis in children. Hand Clin. 1988; 4 633-642
- 10 Price A, Tidwell M, Grossman J A. Improving shoulder and elbow function in children with Erb's palsy. Semin Pediatr Neurol. 2000; 7 44-51
- 11 Chuang D C, Ma H S, Wei F C. A new strategy of muscle transposition for treatment of shoulder deformity caused by obstetric brachial plexus palsy. Plast Reconstr Surg. 1998; 101 686-694
- 12 Curtis C, Stephens D, Clarke H M, Andrews D. The Active Movement Scale: an evaluative tool for infants with obstetrical brachial plexus palsy. J Hand Surg [Am]. 2002; 27 470-478
- 13 Mallet J. Paralysie obstétricale du plexus brachial. Rev Chir Orthop. 1972; 58(suppl 1) 115-204
- 14 Gilbert A. Evaluation of results in obstetric brachial plexus palsy: systems for the shoulder. Presented at the International Meeting on Obstetric Brachial Plexus Palsy, Heerlen The Netherlands; 1993
- 15 Bahm J, Meinecke L, Brandenbusch V, Rau G, Disselhorst-Klug C. High spatial resolution electromyography and video-assisted movement analysis in children with obstetric brachial plexus palsy. Hand Clin. 2003; 19 393-399
Jörg BahmM.D.
Euregio Reconstructive Microsurgery Unit, St. Franziskus Hospital
Morillenhang 27, D 52074 Aachen, Germany