Surgical Technique: Spinal Accessory to Infraspinatus Nerve Transfer in Brachial Plexus Birth Injury.

Nerve transfers, nerve grafts, and tendon transfers have been used to restore shoulder active external rotation in patients with brachial plexus birth injuries. Traditionally used nerve surgery techniques are nerve transfer from the spinal accessory nerve to a suprascapular nerve (SSN) or nerve grafting from C5 to the SSN. However, results are often suboptimal.

Common Pediatric Hand Anomalies.

Upper extremity congenital anomalies in the newborn are second only to congenital heart anomalies. Some of the more commonly encountered upper extremity anomalies are trigger thumb, thumb hypoplasia, polydactyly, syndactyly, and amniotic band syndrome. While some conditions occur in isolation, others are known to commonly occur in association with syndromes.

Congenital Disorders of the Pediatric Thumb.

»: Surgical timing for pediatric trigger thumb treatment is controversial for numerous reasons including the potential for spontaneous resolution, the possibility of bilateral involvement, and anesthesia concerns regarding the developing brain. Hence, a reasonable approach is to delay the surgical procedure until the patient is ≥3 years of age.

»: Preaxial polydactyly is usually unilateral and sporadic, with the most common reconstruction method consisting of excision of the diminutive thumb with preservation and soft-tissue reconstruction of the dominant thumb.